Alternatives to a facelift 2 years after FaceTite? 41 y/o

Question

Hello, I am 41 and I had facetite procedure with liposuction 2 years ago which did not do much to my bulky lower face. I have consulted 2 doctors about getting a facelift done but when I told them that I had a facetite procedure, most of them said that I cannot have a facelift now because RF can interfere with vascular web and chances of necrosis developing is pretty high. Does it mean i dont have any options left at all? I dont want fillers or botox.

P. Alex Montague, MD · Answer

That's a great question. I would say I partially disagree with the other doctors you consulted. Certainly any of the "energy modalities" like facetite can affect the vascularity of the skin, and can certainly cause some scarring beneath the skin that causes the dissection for the facelift to be a bit trickier. I have seen that many times. And while theoretically you may be at a slightly higher risk of skin necrosis due to the previous facetite procedure, a facelift surgery is by no means off the table. You may want to consider a deep plane facelift as classically this approach has less vascular risk. Obviously a full evaluation and medical history would be necessary before making any decisions but from what you've told us in the question I would say a facelift is still an option. There's hope!

Semih Yildiz, MD, FEPOBRAS · Answer

A prior FaceTite treatment does not automatically mean you can never have a facelift. RF-assisted liposuction can create scar tissue and may change the normal tissue planes, so a surgeon has to evaluate the skin quality, prior treated areas, residual fullness versus laxity, and blood supply very carefully. The concern about wound-healing problems is real, but it is not a universal contraindication for every patient. If you ever develop actual skin darkening, open wounds, increasing pain, or drainage after any procedure, that should be assessed urgently by your treating surgeon.

If the main issue is persistent lower-face bulk, the best option depends on what is causing it: residual fat, loose skin, soft-tissue descent, scar tissue, or jaw/parotid anatomy. In some patients, a conservative lower facelift or neck lift can still be considered after FaceTite, usually by a surgeon experienced with secondary or revision facial surgery and with careful skin handling. If surgery is not advised, non-filler options are more limited; more energy treatment may not help much and can add scarring, while additional liposuction is only appropriate if there is true residual fat and good skin quality. Bring your FaceTite operative details to an in-person consultation with a revision-focused facial plastic or plastic surgeon.

Carey Nease, MD · Answer

Although the risk of healing problems may be slightly higher in your case, I would still recommend a facelift if you have excess skin of the jowls and neck. There really is no alternative that will work in your case. The blood supply to the face and neck is very robust, and I do many facelifts after prior procedures like FaceTite with very few issues. Hope that helps!

Eric Swanson, MD · Answer

The FaceTite procedure uses heat to cause fat necrosis and tighten the overlying skin. There are many disadvantages to this approach. Traditional surgical options such as a deep-plane facelift, submental lipectomy, and liposuction tend to produce much superior results. You can still have a facelift despite having had FaceTite, particularly if it is a deep-plane facelift.

Gianfranco Frojo, MD · Answer

I actually find that patient who have had Facetite/RF or any of those type procedures have thicker skin secondary to scarring/fibrosis and the blood supply is not an issue. Most of the problems develop secondary to the more difficult to dissection in the neck/lower face due to the scarring in the normal tissue planes. I believe that a facelift/necklift would likely be the best solution. This will permit sculpting of the deeper tissues such as the fat below the neck muscle (platysma) as well as directly tightening the platysma. This is also the best technique to permit removal of any potential excess skin. I would recommend finding a board-certified plastic surgeon (American Board of Plastic Surgery) with extensive experience in facial aesthetic surgery.

Gerald Minniti, MD, FACS · Answer

Although energy based systems can lead to unwanted internal scarring, making it difficult to divide and move the layers under the skin, it does not cause any injury to the vast network of blood vessels in the face. Any surgeon that performs a lot of facelifts can manage that issue though.

William Portuese, MD · Answer

A full set of facial photographs from all angles in a chin neutral position are required to make a decision about performing a facelift on a person at 41 years of age. You should be able to undergo a facelift procedure after an RF treatment.

Zoran Potparic, MD · Answer

It is very likely that surgeons you have contacted have no experience with face/neck skin condition after RF treatment. It is a fact that vascular supply may be compromised shortly afterwards but it will recover to a normal within several months after surgery. I do not think that many plastic surgeons who do face lifts frequently have a clear understanding how much different is blood supply  in facial skin after RF treatment vs secondary face lifts. It deserves caution  but I do not think that we should stop doing face lift on patients after RF treatment. Good luck.

Jacob Tower, MD · Answer

Hello, hope you are well. Generally speaking, having undergone FaceTite before is not an absolute contraindication to facelift surgery. In most cases, it would be safe to proceed. Especially if a deep plane approach is performed, most of the "lift" is done in a different tissue plane and would reduce the risk of complications such as tissue necrosis.

Best,
Dr. Tower

Best,
Dr. Tower

Ronald J. Edelson, MD · Answer

Non surgical skin tightening really doesn’t work very well as you have discovered. A facelift is really the only thing that works but you may be too young.  So wait five years and get periodic facials in the meantime

Alternatives to a facelift 2 years after FaceTite? 41 y/o

Answers (16)

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