Revision Facelift: A Second Chance at Youthfulness

By: Babak Azizzadeh, MD, FACS

Much like revision rhinoplasty, a revision facelift is a second – or even third – chance to make sure that your face looks both youthful and natural after a previous surgical procedure(s) has left you less than satisfied with your appearance.
There are many reasons why an initial facelift could go wrong; a revision facelift assures that whatever did happen it can be corrected to give you the results you truly desire.
This report will cover the following topics:

  • What a secondary or revision facelift is
  • How it is performed
  • What to know during the consultation
  • How long recovery time might last

What is a revision facelift?

Believe it or not, revision facelift is becoming more common than one might think. Why? With the increasing popularity of cosmetic surgical procedures, more and more individuals who have previously undergone facelift and facial rejuvenation procedures are seeking secondary revision facelift procedures.
A patient who comes in for a revision facelift has significantly different needs than a patient who has not had prior facial rejuvenation procedures. As a result, secondary facelift procedures require special techniques and care because of previous surgical manipulations.

How is it performed?

A revision facelift must be carefully performed. As it is a second- or possibly third-chance procedure, much of the fat and or muscle that might normally be removed is already gone, so the procedure must be done carefully and specifically according to a revision procedure as opposed to a first procedure. Furthermore, many individuals who have been unhappy with their primary face lift procedure, likely required complementary procedures such as volume restoration and skeletal contouring which was not done at that time.
Short flap rhytidectomy facelift provides the best possible outcome for patients who have undergone previous facelift procedures. The short flap rhytidectomy facelift (SFR facelift) utilizes a short skin flap dissection, but this dissection limits the risks of skin issues which is especially important for secondary facelift procedure. Most surgeons utilize long skin dissections to perform facelift procedures which can increase the chance of nerve injury and skin damage for patients who have had previous face lift procedures.
In the Short flap rhytidectomy, the underlying tissue and muscles (SMAS) are elevated with the skin flap in order to obtain the best possible elevation of the appropriate areas that require improvement both in the neck and the face. This SFR facelift furthermore allows multilevel fat grafting to the midface and cheek areas, which are traditionally hollowed and not addressed during traditional facelift procedures. Volume restoration with multilevel fat grafting is one of the most critical procedures that need to be considered in secondary facelift procedures.
Other complementary procedures should also be considered including, skin rejuvenation with TCA chemical peel or fractional (fraxel) skin resurfacing, endoscopic brow and midface lift, blepharoplasty (eye lift), fillers (Restylane, Juvederm, Radiesse, Sculptra) and Botox.

What should I know before a male facelift consultation?

During the facial analysis procedure, five special areas need to be comprehensively evaluated. First and foremost the entire overall skin condition and facial balance will be examined. The skin is an extremely important part of the revision facelift consultation. Many patients who have undergone previous lifting procedures have thinner skin and require special treatment to avoid having complications from secondary procedures. After the skin has been thoroughly evaluated, the facial balance between the upper, middle, lower and neck regions of the face must all be detailed.
There needs to be a solid balance between the forehead, brow, eyelid region and the rest of the face. Therefore, if patients have any sort of imbalance still, the areas will be addressed at the same time with an endoscopic brow lift and blepharoplasty procedures. Also, we now know that the aging process is not just a matter of gravitational laxity, but that significant volume atrophy is also due to the change to the skeletal bone as well as subcutaneous fat atrophy. As a result many patients undertaking secondary facial procedures will require multilevel fat grafting to restore facial volume

How long might recovery time last?

The typical revision facelift procedure allows for a relatively short downtime with patients returning back to work within seven to ten days. Bruising and swelling is limited. The Short Flap Rhytidectomy also limits the risk of injury to the facial nerve especially for the patients who previously had had extensive procedures.

About the Author: Dr. Babak Azizzadeh is the Director of the Institute for Rhinoplasty & Nasal Reconstruction and The Center for Facial & Nasal Plastic Surgery in Beverly Hills, California. Dr. Azizzadeh is one of the leading facial plastic surgeons in the country with an expertise in facial rejuvenation and rhinoplasty. He is the author of top-selling plastic surgery textbook, Master Techniques in Facial Rejuvenation and the upcoming textbook Master Techniques in Rhinoplasty & Nasal Reconstruction and Beverly Hills Beauty Secrets. He has been featured in the Oprah Winfrey Show, People Magazine, NY Times, LA Times and numerous other media outlets.