Why does it appear I have lost all benefit to my lower facelift and necklift? I had my surgery ten months ago. (photo)

My sagging around the mouth has returned and any benefit to my neck is completely gone. Is this normal, are my expectations too high? Am I responsible for paying for the procedure again?

Doctor Answers 19

Facelift longevity

Facelift longevity is a variable phenomenon. Many factors cause a facelift result wane. We are animals that live in gravity and the moment the surgery finishes this force gets to work on the newly lifted tissues. Facelifting doesn't arrest the ageing process either. Many doctors will suggest that their technique lasts longer than others. In my experience this is not the case. In the last year I have revised many (dozens) of Deep plane, smasectomy and suture suspension lifts done elsewhere that haven't lasted beyond 2 years. 

The key to longevity are patient factors and surgeon factors. Those patients that smoke, sun bathe, yoyo weight or neglect skin care might compromise their own result. Some patients will go through stress, grief, illness or emotional trauma in the first postoperative year unrelated to surgery that might effect their result.

If the wrong operation was performed initially then the result might not be as expected. In my experience this is having a face but not neck lift and viceversa or not having any under chin work done initially. From your photos the main laxity is in the midline neck, I suspect this is due to initial backward vector pull that addressed the jowls or lack of under chin work. Hard to tell without a proper examination but keep your rapport with your surgeon as believe me, surgeons care about their results too!

Good luck

London Facial Plastic Surgeon
4.9 out of 5 stars 169 reviews

Some Laxity Is Normal After a Facelift

There is no specific time that a facelift should “last.” The definition of “last” is different for each person, as well. Some think it didn’t “last” as soon as some laxity reappears, and for others, minimal jowl and neck band recurrence is not an issue. Many factors come into play, including the technique used for the procedure, the patient’s skin elasticity, the patient’s lifestyle, and the patient’s age. There is always some laxity that develops immediately after the swelling subsides. From your photos, it appears that you have developed some neck skin laxity and muscle laxity. It may have not been directly addressed in the original procedure, and that is why it is recurring more quickly than expected. A revision might be considered; you should discuss your options with the operating surgeon. I wish you the best.

Louis C. Cutolo, Jr., MD, FACS
New York Plastic Surgeon
4.6 out of 5 stars 13 reviews

My facelift results did not last...

Thank you for your question.  As a facial plastic surgeon and a facial rejuvenation specialist, I have seen patients from other surgeons with your complaint on many occasions.  I cannot comment on you directly as I have not examined you.
What I can say is you did not appear to need a lot of correction in your preop photos, and I do see some changes in your postop photos.  Your selfie was taken with your neck pointed down, and of course you have extra skin in that situation.

I think the best thing to do is to have a good conversation with your plastic surgeon regarding your concerns and determine if another surgery or 'tuck' is right for you.  Keep in mind that we all age at different rates, and based on our skin laxity, may get some recidivism of the skin in the central neck despite the most advanced techniques.

Hope this helps.
Dr. Most

Sam Most, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 62 reviews

Facelift results not as good at a year

There is always some loosening that occurs with time do to the elasticity of skin. Overall, I still see improvements compared with your pre-op appearacne. I am concerned that your neck may have not been adequately treated as there appears to be a residual paltysma band. That is something your surgeon may wnat to address

Best of luck

Michael E. Kelly, MD
Miami Plastic Surgeon
5.0 out of 5 stars 12 reviews

Why does it appear I have lost all benefit to my lower facelift and necklift?

The duration of the results achieved with a face and neck lift cannot always be accurately predicted.  If the natural degenerative process in the skin is occurring rapidly, wrinkling and sagging will also accumulate more rapidly. This is precisely when “tuck-up” or “spot-welding” procedures are helpful.

Without knowing the specific type of procedure performed on you (e.g. skin only, thread lift, deep place face lift, SMAS lift, etc...), it is impossible to speculate what may have caused your fairly rapid recurrence.  

I would discuss your concerns with your original surgeon and see what he or she says.

Good luck!

Parker A. Velargo, MD
New Orleans Facial Plastic Surgeon
5.0 out of 5 stars 47 reviews

Recurrent sagging

Thank you for your question.  After the swelling goes down, some of the tightness will diminish.  Also, facelifts "slow down" but don't completely halt the aging process.  Though it is early at 10 months to notice a recurrence.  I would recommend speaking with your original surgeon and if you are not happy, speak to a board certified plastic surgeon.  My guess is that you would benefit from a revision.  All the best,

Keshav Magge, MD
Bethesda Plastic Surgeon
5.0 out of 5 stars 40 reviews

Face lift results

Face lifts,  if performed well, should last years (>7-10 years).  In todays world where patients desire quicker and cheaper procedures, the market is flooded with surgeons offering minimalist procedures to offer these patients procedures that are quick, with minimal incisions, minimal bruising, etc.  

Therefore, no complete statements can be made without knowing what kind of procedure you had, etc. 

I would have a discussion with your surgeon.

Raghu Athre, MD
Houston Facial Plastic Surgeon
4.6 out of 5 stars 89 reviews

Loss of elasticity

Loss of elasticity in the skin causes some relaxation after surgery, although it is unusual in the first year in someone your age. Not knowing the technique used in your case, it's very difficult to know what's going on. It's best to consult with your original surgeon about your concerns.

Brian K. Machida, MD, FACS
Ontario Facial Plastic Surgeon
4.1 out of 5 stars 22 reviews

Facelift expectations

I find it very unusual for a patient to have the neck laxity you see 10 months after a facelift, especially if they are under the age of 55-60, which you appear to be. I've certainly seen much older patients (>70) get "relaxation" after a facelift in the first 6 months or so. Their skin has such a lack of elasticity that when the tissue relaxes you can immediately see some recurrent laxity. The good news for those patients is that the laxity is WAY better than what they started with. In your circumstance that doesn't appear to be the case. There are certainly more effective facelift techniques than others, and I don't know what technique was used for your facelift. I would discuss your concerns with your surgeon, and if you aren't getting anywhere, consider a second opinion.

Andrew Campbell, M.D.
Facial Plastic Specialist
Quintessa Aesthetic Centers

Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon
4.7 out of 5 stars 26 reviews

Disappointed with Facelift Results

I'm sorry you're not satisfied with your results. There are so many different facelift techniques that  I repeatedly emphasize that a patient should discuss exactly what will be done, the changes that will be made, and the duration of the expected improvements. Not knowing what was done it is difficult to comment on your results. Hopefully you've discussed this with your surgeon.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 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.