2 years post- op facelift. Is it possible to get a mid face and neck lift without causing anymore nerve damage? (Photo)

Question

I had a deep plane facelift over two years ago I have nerve damage and my face dropped because I didn’t do my neck, is it possible to get a mid face and neck lift without causing anymore damage ?

Lucian Ion, FRCS · Answer

Thank you for your enquiry. I am sorry to hear that you have experienced problems with your facelift.
Although it is not possible to say that surgery around the face and neck has zero risk of Nerf damage, some interventions are associated with lower risk levels.
The neck lift intervention in your situation, would most likely require the deep plane approach as your surgeon has most likely already tried to improve the appearance of the neck with a more limited approach.
For the appearance of the face, a mid – face lift may not deliver your expected results, as it does not tend to help the marionette lines.

The version of facelift that tends to be more effective at controlling laxity in the lower face and also absorbs some of the skin excess under the chin is the one where the scars extend in front of the hairline in the temple region. It allows a more effective reduction of the skin excess. it can be carried out in association with tightening of the SMAS or a deep plane approach, which you would probably want to avoid, but the vertical vector is the most relevant contribution.

Finally, the mid face lift is typically carried out deep to the level of the facial nerve branches and should allow a safe intervention

Thomas A. Mustoe, MD, FACS · Answer

Yes it definitely is, but secondary facelifts require much greater experience to safely do with the scar tissue that is present as a result of the healing process.  It is important to do a meticulous dissection and stay i. The right surgical plane.  I personally have
Done hundreds of secondary facelifts including several in tne presence of nerve injury.  Choose your surgeon carefully.

Jeffrey Lisiecki, MD · Answer

First off, your face dropping and nerve damage were not the result of not "doing your neck."  Yes, it is possible to revise your face and neck to reshape your cheeks and fix the laxity and banding in your neck.  I would also recommend targeted facial fat grafting.  While there is always some risk with any surgery, this can be done quite safely by a well-trained surgeon with good technique.

Gianfranco Frojo, MD · Answer

I would recommend a revisionary face/necklift. The deeper structures of the neck need to be repaired appropriately as the central depression is from over-resection of fat and inadequate repair of the platysma muscle bellies in the midline. I would also recommend redraping the face and removing some of the redundant skin. It is very important to find a well-trained actual plastic surgeon (not a "facial plastic").

Gregory S. Keller, MD, FACS · Answer

It is really difficult to tell what you need from the pictures that you are posting.  However, it requires experienced hands to perform secondary facelifts well.  In particular, you have a resting "tired" look that requires specialized attention in the mid-face (your cheeks need a lift, as well as the frown lines and neck).  Seek out an experienced surgeon who specializes in facelift surgery and performs facelifts on a regular basis and has long term follow up of his cases.

John Michael Thomassen, MD · Answer

A high SMAS facelift is safe and can lift your cheeks, jowls, and neck to give you a nice contour.   SMAS techniques in my opinion are an easier to dissect and thereby avoid facial nerve injuries.

Connie Hiers, MD, FACS · Answer

Typically, the greatest risk to your nerves is with the first surgery. The surgeon tends to follow in the same scar path made by the first surgeon.  It is always best to lift the neck with the face since they are connected.

2 years post- op facelift. Is it possible to get a mid face and neck lift without causing anymore nerve damage? (Photo)

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