How you can reverse a skin-only facelift?

Question

How you can reverse a skin only mid facelift that removed 1 cm of skin and left pullled look with square shape face and slanted eyes

Semih Yildiz, MD, FEPOBRAS · Answer

A skin-only facelift cannot be truly "reversed" in the sense of putting the removed skin back. What can be done depends on how long ago the surgery was performed, how much tightness is from swelling and scar contraction, and whether the pulled look is coming from skin tension, deeper tissue position, the eyes, or volume loss.

If this is still early after surgery, the safest approach is often time, close follow-up with your surgeon, scar care, massage only if your surgeon approves it, and allowing swelling and tightness to soften. Many pulled or angular features improve over several months. If the result is mature and still looks too tight or distorted, revision options may include releasing scar tissue, repositioning the deeper tissues, adding volume with fat grafting or filler, revising scars, or in rare cases using local tissue rearrangement. Skin grafting or tissue expansion is rarely used for cosmetic facelift revision and is usually reserved for severe skin shortage or functional problems. Because you mention slanted eyes, you should be evaluated in person by a board-certified facial plastic or plastic surgeon, and possibly an oculoplastic surgeon if the eye shape, closure, dryness, or vision is affected. The best plan is usually staged and conservative rather than another aggressive tightening procedure.

Gianfranco Frojo, MD · Answer

The best way to address the problems related to inappropriate techniques is to revert to a properly done procedure. Usually this include eliminating tension on the skin by lifting/tightening the deeper tissues (SMAS/platysma) and then redraping the skin with minimal tension if possible.

Ajaya Kashyap, MD · Answer

Thankyou for your query. Some pictures will be helpful to give you a proper opinion. However, massages may help as will tissue expansion but the latter may be too drastic. A lot of correction can be achieved by massages and taping and this is what I would recommend. Please discuss this with your Plastic surgeon. All the best!

Mitchell Hagen, MD · Answer

Thank you for your question! I am sorry you have not been satisfied with your results. You do not have any pictures posted, but I can discuss what I typically see in patients who have had these type of lifts. When only the skin is lifted, there tends to be tension on the incision lines and scarring can be a problem. Additionally, most of these skin only procedures have a horizontal pull and do not adequately reposition the tissues vertically giving patients a "pulled" appearance. My solution to this situation often times is a deep plane facelift to reposition the deeper layers more vertically and support the skin so there is less tension for a more natural result. If there were widened scars from the first surgery these can sometimes be removed during this procedure - really depends on the case! I am sorry you are going through this but there are a lot of great surgeons out there that you can see. I recommend seeing several before deciding who you feel comfortable with. Good luck!

Nashielli Torres Espinosa Chiu, MD · Answer

Thank you for reaching out and sharing your concerns. It sounds like the “skin-only mid facelift” you underwent may have created some unwanted tension and distortion in your facial features, leading to the pulled appearance, square-shaped face, and slanted eyes you described.
Reversing or improving the results of a previous facelift is a delicate process, but it is possible with an experienced surgeon. The key is to address the underlying causes of the issues, which may include: 1. SMAS Repositioning:A “skin-only” facelift focuses solely on tightening the skin, which often leads to unnatural tension and results that don’t last. To correct this, a more advanced technique that includes repositioning the SMAS (Superficial Musculoaponeurotic System) may be necessary. This approach restores natural contours and reduces the overly stretched look by addressing the deeper layers of tissue, not just the skin. 2. Volume Restoration:Loss of volume in certain areas of the face may contribute to the square or harsh appearance. Fat transfer can help restore a softer, more youthful contour by filling areas such as the cheeks or temples while complementing the facelift revision. 3. Correcting Eye Appearance:The “slanted” or pulled eye look can be addressed by carefully adjusting the positioning of the lateral canthus (outer corner of the eye) and balancing the surrounding structures. This requires precision to achieve a natural and harmonious result. 4. Scar Evaluation:It is essential to assess the scars resulting from the previous facelift, as they may contribute to the tension and overall appearance. Evaluating the condition and placement of these scars will help determine the best approach for revision surgery. 5. Personalized Revision Surgery:A revision facelift focuses on tailoring the procedure to your specific concerns. The goal is to reverse the effects of the previous surgery while creating a more balanced, refreshed, and natural appearance.
To provide the best recommendations, it’s very important to evaluate your individual case thoroughly, including the existing scars and areas of tension. I would suggest scheduling a consultation or video call

Steven H. Wiener, MD · Answer

Thank you for your question.  A skin only facelift was probably performed by a non-plastic surgeon.  Facelift techniques used today involve tightening or elevating the deeper structures of your face.  This includes a SMAS type lift of a deep plane lift.  This moves the skin and underlying deep structures, resulting in a more natural result, and a longer lasting result.

Connie Hiers, MD, FACS · Answer

Time will reverse a lot of changes from a facelift. Perhaps you really did not need a facelift. Next time, consider radiofrequency with micro-needling to tighten skin and build collagen. Photos would have been helpful, and I could have been more specific.

Mats Hagstrom, MD (license on probation) · Answer

First and foremost, I recommend you rely on in person consultations exclusively.
A mid facelift doesn’t remove any skin.
A facelift is a permanent and irreversible procedure.
It may be possible to revise the outcome to get a better result.
To make an assessment, we always need to see a complete center of proper before and after pictures.
 if you don’t have before and after pictures, then ask your surgeon to forward the pictures they took.
I recommend you schedule multiple in person consultations with plastic surgeons in your community of focus exclusively on facelift surgery.
Look for senior plastic surgeons who have at least one or two decades of facelift experience.
 Best,
Mats Hagstrom MD

How you can reverse a skin-only facelift?

Answers (8)

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