I had a face and neck lift 5 months ago. There is still laxity in the neck area which is concerning and disappointing. Is it true that sometimes a surgeon can only take up so much laxity the first time and that revisions are sometimes needed to achieve the desired results? What is the suggested time to wait? Thank you.
Are Revision Facelift and Neck Lift Surgeries Common?
Doctor Answers (15)
Skin still lax after a facelift
A picture is worth a thousand words, so in absence of before/after pictures I'll do my best.
There is a delicate balance between too tight and not tight enough when performing a facelift.
- Not tight enough and there is some residual laxity and the patient may be unhappy
- Too tight and the patient looks scared and they are definitely unhappy
No surgeon can do with a knife what a patient can do with their hands... A patient can pull the skin up and it looks so easy and wonderful. In surgery, all the pull is at the margin of the ear and back of the neck... as you move more toward the midline, the pulling effect gets less and less... unfortunately, those are the areas that most patients are looking to improve.
Often there can be complimentary procedures to help tighten some of the residual areas, depending on the degree of laxity. A chemical peel or laser resurfacing are two reasonable options. Before considering revisional surgery, I prefer to give the skin up to a year to completely finish healing and show me its final result
Revision face and neck lift is common in a limited group of patients.
In some patients which includes patients wtih::
- Familial poor skin elasticity
- Those who have lost a great deal of weight
- Heavy round faces with short necks
- Male patients with thick short necks
we will tell them they may need a "double lift" technique.
This is because even if you tighten the skin to the safe limit at the first operation, there is likely to be so much "stretch back" that the result is not satisfactory. The second operation will usually result in a much more improvement than the first because the tissues are lined with scar and have been trained (delayed) from the first operation and can tolerate more tension.
The second operation is usually just done in our office and the recovery is much easier than the first.
Revision Facelift Surgery
Unfortunately, every Facial Plastic Surgical procedure carries with it the possibility of revision. At the same time, revision surgery, especially for Facelift, should be relatively rare; a low revision rate (1-5%) is typical of an experienced Facelift Surgeon who take the time to understand an individual patient's concerns and expectations. The possibility of revision increases when a patient is overweight, or has a very heavy neck. The classic timing for revision is about a year, by can vary based on the circumstance. The best place to start is with a frank discussion about your concerns with the Surgeon who performed the procedure.
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Revision facelift and necklift
If the neck skin was entirely undermined and released at the time of the first surgery it would be uncommon to have laxity there unless your skin elasticity was very poor. If only liposuction was done there, you might need to go in and do the undermining of all the skin to tighten it up.
Revison face lift
Sometimes a revision is necessary because there is residual laxity in the neck or cheeks. Probaqbly happens in less than 5%.
Revision Facelift and Neck Lift are not common, but sometimes necessary to remove excess neck skin
A revision of a Facelift and or Neck Lift is occaisionally necessary, but not usual.
The most common revision is the neck.
Sometimes the lax neck skin cannot be totally tightened even with an excellent Neck Lift and Platysmaplasty. In these cases a revision is necessary and usually involves a local procedure which includes excision and removal of excess neck skin with a visible external incsion on the neck beneath the chin.
If a good complete Facelift and Neck Lift have been done and lax skin persists on the neck, local excision is required. It is not done at the time of the original surgery in the hope that an external incision will not be required.
Revision surgery after facelift.
At five months you should be seeing an excellent result not thinking of a revision. Without a picture to see where you started it is hard to be specific about your degree of laxity. I would recommend you discuss this with the surgeon who did the surgery and see what he/she recommends. I normally do not re operate on face lifts for a full year to let everything settle down unless there was a clear mistake made and I feel it can be corrected. This shortens the time period the patient has to endure a bad result.
When is a right time for revision facelift surgery
It depends on the degree of your neck laxity prior to the surgery. If you started with severe aging of neck, it would be very difficult to have no laxity after the surgery. However, with mild laxity of neck you should not have to have another lift this soon. It all depends on the surgeon’s technique and his comfort and understanding of facelift surgery. If there is any chance of post operative tissue laxity due to patient’s anatomy, surgeon must communicate that to his/her patients.
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.