I'm 65 years old and had a facelift seven years ago that I was delighted with. I'm beginning now to see the need for perhaps another minor procedure even though I do Botox. I wasn't happy with my Juvederm injection for the nose-to-mouth line so prefer not attempting that again. Any suggestions as to another facelift and the type or would this be an overkill on my part? Thanks!
Is It Safe to Have Another Facelift Seven Years After?
Doctor Answers (22)
Secondary or revision facelift considerations
Secondary facelifts are indeed gratifying procedures, and usually quite safe in the medically cleared patient. For patients your age, our practice typically would request you get a stress test, cardiogram, physical examination and blood tests.
The bigger question is how the secondary procedure is done. Often, after a facelift there are minor alterations of the hairline and ear area. If specific steps are not taken, these irregularities get worse.
The skillset for secondary facelifts (and many of the adjunctive procedures to offer the patient) are completely different from the first time surgery.
With secondary lifts, the goal becomes correcting of the hairline, tragus (bump in front of the ear), earlobe, previous scarring, eyelid shape, especially from prior lower eyelid surgery, and restoration of hair lost to prior surgery and aging.
Even more important than the corrective aspect of the secondary facelift is the volume aspect. Valuable volume lost to time will NOT come back by itself. It must be strategically placed in areas of hollowness, and readjusted from positions where the volume is detrimental to a position where the volume enhances the appearance.
Also important is the appearance and length of the upper lip, the earlobes, the skin surface itself, since all of these structures have been aging (and often lengthening) over time.
If you want to obtain your best result, your prospective surgeon should be comfortable with these concepts, and probably will bring them up at the time of consultation without you having to say anything.
Secondary Facelifts and your appearance
The second issue is whether you are an appropriate candidate physically for a second facelift. The fact that fillers around your mouth did not really do the trick is no surprise. You might consider fillers or fat to specific areas of your face that would give you a more youthful and full faced appearance rather than the appearance you will get by simply pulling your skin tighter. The mid face, cheeks, jaw line, and temples are four such regions.
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Secondary or Revision Facelift Considerations: Safety
Secondary facelifts are frequently performed procedures with pleasing results and usually minimal problems in the appropriate patient with medical clearance to undergo the procedure. The procedure requires greater surgical expertise and experience, since some secondary procedures are technically easier to perform while many are more complex.
Secondary facelifts are similar to a first facelift in that they need to be individualized based on your concerns, anatomy, desired outcome, and what is realistically correctable. Often a minilift plus subtlely adding volume in areas where it is deficient with micro-fat grafts, without overcorrection, may be all that is necessary. Fillers have their place, but as you have experienced, they have significant limitations and don’t replace a lift. There is no one best surgical technique. The factors to consider that are more important than a specific technical type of facelift are the skill, artistry and experience of the Board Certified Plastic Surgeon.
No matter which procedure you have, the goal should be a natural appearing result that puts the facial features in harmony and balance. Risks can be minimalized by undergoing the secondary facelift in a facility that is accredited by a national organization, like the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), or licensed hospital and being monitored during the procedure by an appropriate anesthesia provider.
Generally the gain from a secondary lift lasts 7-12 years, but you should always look fresher than a twin, if you have the procedure and the twin does not.
Robert Singer, MD FACS
La Jolla, California
Safety of a Secondary Facelift
If you are healthy, another facelift, if indicated, is quite safe and the proper thing to do. However, secondary cosmetic surgery is more difficult and requires more expertise and experience as facial reshaping can lead to facial deformities unless one understands how to do secondary facelift surgery. In general, one must release the scar, reshape the face and neck, and refill the deep fat compartments to give the patient a youthful non-operated look. Most facelift techniques last about 7 to 10 years.
Facelift After Seven Years
Secondary facelifts are not uncommon. Depending on the appearance of your jawline, neck, and jowls, a secondary facelift can help restore some of the youthfulness back in place. Secondary facelifts can be performed safely and in general pose no additional risks than a primary facelift.
Safe to have second facelift at age 65
It is acceptable to do a facelift seven years later after the primary facelift. The goal for secondary facelifts is usually to tighten up the jowls again and tighten the laxity and loose skin in the neck including the neck cords that occur by age 65.
Nonsurgical facelift with fillers
Sometimes at this stage you can obtain similar results with a Nonsurgical facelift using fillers. I prefer Radiesse or Perlane since these products last longer. However, if you need a more dramatic tightening then either a Mini facelift or Full facelift could be indicated. In your case, as long as your medical condition is good then there are no contraindications to proceed. Good Luck!
Facelift After Seven Years
Question: Are there different types of mid facelift?
Answer: There are many types of the facelift procedures and there are different approaches to the mid face including a direct open approach, endoscopic approach, modified endoscopic approach, approach through the lower eyelids. In general, I do not like to take one portion of the face out of context with the remainder of the face and neck. It is important to have a nice smooth contour of the mid face, lower face (jowl/jawline region) and neck. Taking one part out of context runs the risk of distortion. Accordingly, I usually prefer to approach the mid facelift at the same time as I am approaching the remainder of the face, jawline and neck. There is better visualization with access to important anatomical structures for redraping of the appropriate structures in a manner to achieve natural smooth contours.
Mini-Facelift with SMAS procedure and Fat Grafts
In light of your previously successful facelift 7 years ago, you might want to consider having a mini-facelift done now. If you did not have a SMAS procedure done at the time of your prior facelift, the SMAS procedure, which tightens the deeper tissues beneath the facial skin, should be done at the time of the mini-facelift. You might also want to consider having some of your own fat grafted into the naso-labial folds (nose-to-mouth lines) at the time of the mini-facelift. This will eliminate the need for Juvederm or other fillers to that area. If done correctly, all of these procedures will help you look fresher and younger, but not overly tightened.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.