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Why Didn't My Facelift Work? (photo)

Hi There. I am 44 years old, athletic, non smoker or drinker, healthy and have never had a problem healing. Six months ago I had a mid facelift, anterior neck lift and upper blepharoplasty to address facial sagging that no amount of exercise could cure. I did my research and communicated my expectations clearly with the surgeon. I healed well, the scars are almost invisble BUT I see no difference. I look almost exactly the same as before. Why didn't my surgery work? Why did it fail? I'm so upset.

Doctor Answers (20)

Unhappy Facelift Patient- Expectations vs Communication


It is almost universal that surgeons do not handle patient expectations very well. We all try to alleviate any concerns with our unbridled enthusiasm for what we do. Unfortunately this can muddle patient communication with the surgeon. In your particular case I see none of the usual signs of aging that warrent the procedure you had. Therefore, your expectations are unmet even though you communicated your desires directly to the surgeon.The first tenet of the Hippocratic oath is to do know harm. The first tenet of cosmetic surgery is to make the patient look better. I believe the more experienced surgeons are more likely to achieve both goals which have not been met in your instance.

Birmingham Plastic Surgeon
5.0 out of 5 stars 7 reviews

Facial surgery didn't work--why?


Over the past 35 years of facelifting,etc. I go over pictures I take of the patient and make them show me what THEY want. I personally do not like mid facelifts in your age group or anterior neck lifts. I think a chin-prejowl implant =and a facelift would have given you more of what it sounds like you wanted. Hind sight is always 20-20. These things can be done to improve the situation but you will have to decide when and if to do that.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

No difference after facelift

Part of the problem is that we don't see clear and significant signs of facial aging and laxity before your procedure. Any result is bound to be very subtle at best.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 31 reviews

Unsatisfied Following Facelift


         I think that your aging changes are more subtle, which means your genetics are good and you take care of yourself.  At this point, fat grafting to the tear troughs, cheeks, and marionette lines could improve and rejuvenate your face without having to undergo a major surgery again.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 244 reviews

No results after a facelift


IUt is very imprortant to manage patiets expectation.  Also, the plastic surgeon needs to sell the product he can deliver.  Clearly, you are not happy.  Looking at you photos i would not advised a midfacelift but possible a facelift which would have addressed both more aggressively.  You would not have noted a major change because your facial aging is minimal.




Miguel Delgado, Jr., MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 37 reviews

Minimal changes after surgery


When reviewing your photos I agree that your improvments are sublte. In My practice young patients like yourself see real changes to their facial features that they would like to correct. Unfortunately such subtle changes are often not possible to improve enough that its worth having surgery for. I do see some improvements in your after photos but they are sublte and I can understand your dissapointment

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
5.0 out of 5 stars 64 reviews

Aging versus genetics


When I see a younger patient like yourself I am always cautius to take a step back and evaluate what it is the patient is really unhappy about. For the younger group it is either:


1) Real and early aging. Lifting procedures can help here


2) No real signs of aging - Counseling and clear demonstration of how a procedure cant help is the ethical thing to do


3) The third category is you - you work out and have volume loss in the face as well as some underlying facial skeletal deficiency or changes


The third category is so easy to miss. You really have to study a patients face to catch it.  You can still achieve those results but it would mean additional procedures. At the very least make sure you consult with someone who can really see what your seeing and understands your desires.

Benjamin C. Marcus, MD
Madison Facial Plastic Surgeon
4.5 out of 5 stars 32 reviews

Consider fat grafting and neck/jowl lift by an experienced plastic surgeon

Hello, Thank you for the question and photos. Your preoperative photos show mild laxity and moderate volume loss. Volume replenishment is an important part of facial rejuvenation especially the midface. The neck and jowls are unchanged but that is to be expected with a midface lift only. I think a neck.lift, jowl loft and fat grafting to.the cheeks and upper/midface area would suit you well.

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 101 reviews

Incomplete effect after lifting procedure


Unfortunately, many times minimally invasive procedures result in minimal improvement. These types of procedures especially midfacelifts in patients with minimal sagging only result in subtle degrees of improvement as may be your case. Perhaps some fillers and a pre-jowl implant may better suffice your needs. Good luck.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Failed Facial Rejuvenation Procedure


A significant reason of your lack of results is the mismatch between the amount of facial aging and the surgery used to treat it. A midface lift seems to be a solution for your midface that is bigger than the problem. Conversely, an anterior neck lift seems like an inadequate treatment for your chin and neck/jawline concerns. A chin-prejowl implant and a limited facelift approach would seen better suited for improvement. It is not that your surgery failed because of how it was executed or healed, it appears that the 'failure' may have been in the initial decision as to what to do and how it would meet your expectations. (.i.e., treatment planning)

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 34 reviews

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.