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How Long to Wait for Lower Face and Neck Lift Revision Surgery?

I am 4 months post op from lower face and neck lift. When I look forward with my head raised my jawline looks perfectly smooth. If I smile, turn or lower my head I have terrible creasing and folds in my left jawline and lower cheek (see photo). My right side looks perfectly fine. My PS thinks this may be scar tissue and wants to undermine this area and under my chin again.

If this is scar tissue, why does this happen? What's to prevent this from reoccuring with a revision? How long should I wait for revision surgery?

Asked 29 months ago by Bunny123 in MA
4 months post op from lower face and neck lift 4 months post op from lower face and neck lift
Sort 16 expert answers by:
+3

Neck Lift Revision?

After reviewing your photos, I would suggest that you wait at least 6 months before revisional surgery. Your result may improve with the passage of time. If it doesn't, then waiting will allow the soft tissues to soften. This will increase your likelyhood for a better result. Good luck.
Douglas L. Gervais, MD
Minneapolis Plastic Surgeon
+2

Wait a year for face/neck lift revision surgery.

It is important to wait at least a year prior to embarking on further revision surgery on your neck. The pleats that are present upon looking to the left are caused by excess skin contracted down to bare platysma with loss of intervening fat. The posterior portion of the skin appears it has also been rotated too far anteriorly in the postauricular area and needs to be re-draped.
William Portuese, MD
Seattle Facial Plastic Surgeon
+1

Creases on the neck after lower facelift

Dear Lower Facelift Patient from Massachusetts, The creasing or “pleating” appearance of skin on your left side of the neck could be contributed from inadequate undermining and re-draping of the skin flap during the surgery. If you wish to correct it, I would recommend waiting another 6 months before pursuing revision. Good luck  
Kevin Sadati, DO
Orange County Facial Plastic Surgeon
+1

LOWER FACELIFT & NECK LIFT REVISION - WAIT 1 YEAR BEFORE DOING THE FACELIFT AGAIN

Revision surgery of any kind should not be performed before six months have elapsed. Ideally one year is even more prudent. If the area in question was not treated at all at the time of the initial surgery, then revision surgery may be carried out sooner rather than later. Dr. Carlos Cordoba MDCM, CSPQ, FRCS, FACS Plastic & Esthetic Surgeon 4055 Ste-Catherine O. Suite 100 Montreal, QC. Canada H3Z 3J8 514-932-7667
Carlos Cordoba, MD
Montreal Plastic Surgeon
+1

Face lift

 After review your pictures I believe you will need a revision but is important still to wait at least six months after your surgery.
Alejandro J. Quiroz, M.D.
Mexico Plastic Surgeon
+1

Revision after a lower face and neck lift

A lower facelift is an excellent option for patients who are interested in recontour and the jawline and neck. After such a procedure, patients should expect a recovery process that may last between four and eight months. This is especially true if liposuction was performed at the same time. You should consider waiting at least 8 to 10 months before considering a revision or elevating this flap of skin.  
B. Pat Pazmino, MD
Miami Plastic Surgeon
+1

At least 6 months waiting period for lower face and neck lift revision

I agree with the majority of posting doctors to wait at least 6 months. As to cause, it could be many factors. Bleeding in tissue, poor dissection and draping of the skin, residual fat deposits, infection localized to the area, etc. No matter the cause you still need to wait the 6 months. Hope that helps.
Darryl J. Blinski, MD
Miami Plastic Surgeon
+1

Timing of revision facelift

You should wait a couple more months and consider a revision at that time. Either your skin wasn't undermined enough, or it was redraped poorly or you have bad sun damage making pleats in the skin. The first two of these can be improved but the entire operation needs to be redone, not just a tiny revision.
Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
+1

Wait a minimum of 6 months from the original surgery; the longer the better.

The "pleating" that you exhibit may either be a result of inadequate undermining (elevation) of the cheek/neck skin off the underlying soft tissue (fat and muscle) or scar "adhesions" where the cheek/neck skin attached unfavorably. At any event, waiting a minimum of 6-12 months after the original surgery will enable your surgeon greater safety in reelevating the skin. Good luck.
Lavinia Chong, MD
Orange County Plastic Surgeon
+1

Revision Face Neck Lift, Tuck Up Face Neck Lift

Question: How long to wait for lower face and neck lift revision surgery? Answer: In general, if there are residual findings in the lower face and neck area following rejuvenation surgery, at least four to six months postoperatively is prudent. Revision of postoperative findings may be minimal or more extensive depending upon the findings. In addition, the aging process continues with time. In some cases, a minor tuck- up procedure might be warranted in one, two or three years following... more
Sigmund L. Sattenspiel, MD
Freehold Facial Plastic Surgeon
+1

Revsion Facelift

HI, From the photos it appears that the left neck area was not undermined completely or scar tissue may have developed. To correct this, in my opinion, the undermining should be performed from the post-aurcular (behind the ear) area. This will release the skin and SMAS muscle and allow it to be properly pulled and retrimmed. I dont believe you can correct this from undermining under the chin. I have performed revision facelifts as early as 4 months post-op with good results. Of course,... more
Oleh Slupchynskyj, MD
New York Facial Plastic Surgeon
+1

Prominent Neck Creases After Facelift

These creases can be from adherent scar tissue forming bands or sutures under the skin pulling that area towards the ear. If there are permanent sutures, those would need to be cut. If there are scar tissue bands then undermining like your plastic surgeon is recommending should work. Four months post op is a reasonable time period. Your healing is complete and you should recover quick. The most important thing is NOT to remove any fat as usually the fat covers up any irregularities and keeps... more
Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
+1

Depends on what was done & what needs to be done

Hi Bunny, Most of us agree that waiting 6 - 12 months is appropriate before doing any touch-up or revision procedures. The reasons for this time period are two fold: 1. While swelling and bruising on the skin fade quickly, there is still a lot of healing that is going on under the skin. It is best to let this healing happen in order to properly assess and address any areas that can be or need to be improved 2. Much like picking at a scab, lifting skin flaps, removing skin and tightening the... more
Kamran Jafri, MD
New York Facial Plastic Surgeon
+1

Undermining the area may help, but I would wait

Undermining the lower face and neck may help, but I would wait 6-12 months from the date of surgery. If improvement occurs over the next 2 months, then additional improvement may occur thereafter. If there is no improvement over the next two months, a revision surgery is quite reasonable. Injectable fillers can also be used, but they are not permanent solutions (unless you plan to continue them on a regular basis). Without a picture of the right side of your face, it is not possible to... more
Kevin Ende, MD
Manhattan Facial Plastic Surgeon
+1

Wait 6-12 months.

 See your surgeon and get a second opinion if there is any doubt. Remember that you will always have extra skin folds when you bring your chin down.
Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
+1

You should wait at least 6-12 mos before proceeding with Revision Face Lift Surgery.

I read your concern, and I reviewed your photos. Are both photos after surgery? Clearly the folds are more prominent with smiling. If they're also present at rest (left photo). you would be surprised how well these can improve with Injectable Fillers. If your skin was very sun-damaged and wrinkled before surgery, it's not uncommon to see unsightly folds in new places. Without examining you, I can't be sure that Fillers are appropriate for you. It's worth investigating, however, since it's an... more
Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
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