Is it common to have a facelift revision?

By kbarbee on 16 Dec 2011

I had a lower face lift, neck lift and neck liposuction done 5 weeks ago. It looked fabulous for first few weeks while there was still swelling. Healing has gone very well also. About a week ago I noticed everything began to loosen again. My jowls, which was my primary concern have come back. Certainly not to the point they were prior to surgery but my jawline has relaxed so much and there are little loose skin pouches. I am so disappointed. Nobody has even commented that I look any different. I scheduled an appt. to talk to my surgeon next week and it will be a difficult appt. for me. I find it hard to ever complain but I do not think I should see this at only 5 weeks out. I am also concerned about the money and hope that he will not charge me for a revision. Just so disheartening when I finally got up the nerve to have the surgery. Any one out there with advice or similar story? I would appreciate any feed back. And will a revision cause more scarring? Please advise, thanks!

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NHaven 19 Apr 2013

Dear Marjayrey, earlobes can be fixed successfully but I don't know if it's an office procedure. Ask the doctor board on this RealSelf site and attach a close-up picture of your ears if you can. The pouches under your jaw may relax and fill in over the next year. I, actually, went to another PS for fillers on either side of my chin because a fold developed when the fat from my tummy that my PS injected "disappeared"! What is a "tweak" anyway? I think it means "shut up and don't criticize me!"

Lilacs 18 Apr 2013

Yes, being a victim of truly bad surgery is not only exhausting, it is SOUL MURDER. When I expressed caution, the surgeon (E. Bortnick) who did my imitation "neck lift," laughed & said he hadn't killed anyone yet! YES HE HAS! He's killed every patient that he harmed, and I suspect that there are many! Being a victim of liars who damage the face that you were born with commit soul murder. And it has devastated my life.

Fixmyface 19 Apr 2013

Good lord, that man should have his license revoked then. I can't imagine the horror. (I was reading your other comments as well). I love my fl because prior I couldn't even hold my head up and didn't want to be seen. I felt like a gargoyle with my neck and jowls and I was unhappy with my looks for decades, so it's nice to be able to hold my head up now and even feel pretty. I wanted some revisions and he said he does them free within the first year but already I notice a change in my ps's attitude (almost as though I'm ungrateful or something and says 'I spent a LOT of time on you'.) Now I'm afraid to ask. :-(

Fixmyface 1 Apr 2013

I had my 3 month appointment today. I want to ask him for revisions at some point if some issues I am not happy with don't change. He offered revisions free of charge within the first year and was so great about it. I have noticed a change in his demeaner after my last visit when I made comments to his assistant about some concerns. I feel like they offer things but really don't want to have to do that and take it as an insult perhaps? I don't like seeing an arrogant side coming out from a man who seemed very humble from day one until my prior appointment and todays. I guess I was too foolish to think finally there is a humble, caring doctor...but I am probably being too harsh today because I felt blown off when trying to talk about my own concerns.... Speaking of Lifestyle Lifts, on my way home I saw a building with that on it, I guess they have their own offices now? I wouldn't go for that at all.

NHaven 21 Mar 2013

Dear Lilacs, Welcome to the group! What is an "unrealistic expectation" when we are bombarded with TV ads, promises and marketing doctors! If your doctor revised "in the office" I doubt the SMAS was part of the revision but he may have re-anchored the fibrous tissue that attached to the muscle which he addressed in the original surgery. I think the less experienced doctors pull on the muscle layer instead of actually "freeing" it and repositioning mostly because the latter has a higher risk of nerve damage in less experienced hands. I now believe that plastic surgeons dislike their female patients who come for elective surgery and resent them; of course they love their money. I think it's a deep seated resentment that they don't consciously display but their hard core selling techniques and vague disrespect after the surgery seems pretty common. Not sure. That's my experience.

Lilacs 22 Mar 2013

Thank you for the welcome, NHaven. I wish I'd joined this forum long ago. Regarding my FL surgeon who did a revision in the ofc., he was very experienced and known as being good with FLs, although I now know he's rather out-of-date. But what happened to me was he was suddenly in a seething, hate-filled rage before his 1st. FL, and he anchored my face DOWNWARD instead of upward. His proposed revision (in the office) was supposedly to correct that, but he didn't bother to really reverse this downwardness and only lifted about 1/2 way up to normal. Surgeons I've seen since have been shocked to see such an unusual outcome, esp. from an experienced FL surgeon. They have mentioned wrong vectors, etc. I didn't tell them about Gutek's ongoing horrific mood swings that he ACTED on because I was afraid they wouldn't believe me and think the problem was me. This is the horror of the hostile surgeon -- they can just call the patient "unrealistic," & put them on a black list, if the patient dares to ever tell the truth.

doctordeb7 7 Jan 2012

Yes, I had the same thing happen. The doctor kept saying, "relax, it takes time, I can tweak any issues, yada yada yada..". Long story short he redid the lift at the four month mark. Now, almost a year later my jowls are returning because it seems he used fat filler to fill the space in front of the jowls instead of elevating the SMAS properly to a higher level and securing it. So, my opinion is, if you decide to use the same PS for a revision ask him if he will lift the SMAS or use fillers. The filler doesn't last even if it's your own fat. And when the filler dissolves and the jowls return there is a funny folding of the skin. I've seen this posted by other RealSelf commenters. While money is always an issue, unless your PS has his own surgical facility you will get stuck paying for the surgical suite and anesthesiologist anyway even if the PS says he won't charge. Best wishes to you. One good thing, as time passes the puffiness also goes away and you return to a more natural appearance. Overall, the jowls are less prominent but still no excuse for sloppy surgical performance.

2trusting 9 Mar 2012

Ooooo boy,
Do I ever agree with you, doctordeb7 ! I think this whole lower SMAS thing should be thrown out as an option to plastic surgical procedures, UNLESS you're one of the about 5% that it will work for. AND it is being given to people who might have benefited from other procedures. I had a Life Style Lifts done in 2010 and I wish I had never believed their glowing promotionals about their most excellent Drs. in the whole wide world. Their procedure is a lower SMAS and now I see their promo for Lower Lift Reviews. Interesting.

NHaven 10 Mar 2012

The strange thing is LSL gets the bad wrap. Yes, they misrepresent in their TV promos, but even board certified plastic surgeons that are independent use the same procedures. On the one hand they bad mouth LSL as a "skin only lift", but it isn't necessarily so. Lifestyle, like you said, is a SMAS procedure. I told my plastic surgeon I did not want a Lifestyle lift so he did a SMAS lift referred to as a MACs. Guess what? It was the same thing as a LSL. Same thing....

2trusting 10 Mar 2012

I know NHAVEN you have to practically go to plastic surgery school to learn all the names, which muscles will be address etc. etc. etc.. and the lower SMAS goes under many alias they. I know others are performing it but in general if someone is really good they'll offer you a great deal a other alternatives. I wouldn't let anyone touch me again though that works for a corporate medical practice who has to have a high volume of victims in order to support their advertising habit and all their lawyers.

NHaven 11 Mar 2012

Amen to that 2trusting!

2trusting 11 Mar 2012

And if LSL is getting a bad wrap it's because they've been lyinig to people for the last over a decade!!!! It all comes out eventually. And They're learning they'll have to pay the piper one of these days. Oh YES! The Lake of FIRE!

2trusting 11 Mar 2012

And their little Debbie Boone TOO!!!

Lilacs 21 Mar 2013

Doctordeb7 -- You mentioned he did a revision at 4 mos. My ps proposed a revision at 4 months, also -- "in the office." I thought there was supposed to be a wait of about a year between surgeries -- so I waited 9 mos. And I suspect that he didn't "lift the SMAS" in this revision, so it didn't really fix the damage. (In the 1st surgery, he anchored my face downward, & in the 2nd, he lifted some but not enough!) What I'm getting at is this -- maybe these guys offer a revision at 4 mos. that is not a real revision -- just a "patch job" to improve it a little, to "get you out the door," & then, of course, it doesn't do enough or last longer term. I know in my case, the "revision" was just a cynical "cover up," that he knew was not the true revision I needed. Unfortunately, I made the mistake of complaining about the 2nd, & when he offered a 3rd "revision," I didn't say yes right away -- SO HE DISCHARGED ME & blamed me for having "unrealistic expectations." I never had unrealistic expectations -- I was just guilty of believing his unrealistic promises ! So I was abandoned through no fault of my own. Some ps's are caring and kind, but the ones who are cruel are truly monsters.

marjayrey 13 Apr 2013

doctordeb7 - So.....I have my 6 month follow up this week, and I recall my PS saying that he'd "tweak" anything I needed, but after reading your post, I wonder if it would be worth it. Maybe he'd let his fee slide, but he does his surgery at a center, so you're right that I think I'd be stuck paying those fees and frankly, I don't have any more money for this. Plus my earlobes look all messed up, so wondering if he'd maybe at least fix those, perhaps in his office as it wouldn't involve much more than skin? Have you ever heard of that? I still have some pouches under my jaw, and just feel that I spent all this money and there seems to be little difference. I am hoping maybe if I can lose some weight, and give it more time, maybe things will look better. I still have pain and tenderness and can't believe it some days....I'm exhausted from dealing with the constant issues.