Issues Involving Facelift Revision


Facelift revision poses some unique challenges not encountered in the previous or primary surgery.  For this reason the surgeon must carefully listen to his patients’ concerns and cosmetic goals to provide results that will satisfy them.

“Immediate” facelift revision (as opposed to another surgery down the road to address continuing aging of the face) often deals with poor scarring and residual skin laxity or other signs of “under-correction.”  The consensus is to wait 6-12 months to make sure that all the swelling has already dissipated, the skin has fully redraped to the final contour, and the scar has reached its maturity.

But in the event of over-correction, i.e., the face looks overly tight, oftentimes the best treatment is to leave it alone and allow the skin to settle and relax.  While this could be frustrating for patients, another surgery might worsen the problem.  For this reason a good surgeon knows the delicate balance between achieving results that are too tight and not tight enough.

It is important to note that not all revisions require another surgery.  For some patients whose nasolabial folds or laugh lines (deep grooves between the nose and side of the mouth) remain after their facelift, dermal filler injection is typically enough to correct this appearance.

Juvederm, Restylane, and other hyaluronic acid-based products are generally enough to soften the appearance of laugh lines, although one downside is that their effects can only last 6-9 months.  For patients seeking longer lasting results, Sculptra might be a good option as its effects can last up two years.

Fat transfer or graft is a good alternative to dermal filler injection, although it requires a steeper learning curve on the surgeon’s part.  First and foremost, it entails gentle collection of donor fats, proper purification of grafts, and correct re-injection of the fat cells to make sure that they form a new blood supply.

Fat transfer and dermal fillers, which are also called volumizers, are also ideal for plumping up the hollowed cheeks.  They are particularly helpful in creating a more youthful and balanced appearance. 

It is important to note that no amount of lifting can correct hollowness, thus volumizers have become a common ancillary procedure of facelift surgery.

In the hands of a board-certified facial plastic surgeon who regularly performs facelift, the surgery has a very low revision rate, assuming that the patient maintains a healthy weight, and avoids smoking and sun exposure (and other factors that compromise skin quality).
Article by
Beverly Hills Plastic Surgeon