Facelift Revision for Asymmetry?

I had a facelift 5 mos. ago. Surgeon did extra tightening toward mid-ear on Right side, to "lift mouth" more, but mouth is more downward on Right side + Right side doesn't feel "supported" upward as it does on the left. I'm afraid this is hard to describe -- it doesn't look like the Left side. Can this be revised after a year? (This is this surgeon's SECOND facelift on me, and then 2.5 months after 2nd surgery he "dismissed" me.)

Doctor Answers 17

Facial Asymmetry, Facelift Revision

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Many good comments to this post.  Facial Asymmetry is very common.  I ask my patients, "What percentage of people have asymmetry to their faces?"  Most patients will answer 10-50%.  The answer is 100%.  What this means is that most people do not realize the facial asymmetries that we all have because it LOOKS NATURAL.

There is no way to know if an asymmetry existed before a procedure unless you review the before and after pictures.  The vast majority of facial asymmetries are present preoperatively.  There is a saying in plastic surgery - after a procedure, our vision gets better, and our memory gets worse!  We start to see things that we never saw before...  And very few patients remember what they looked like before the procedure.  Many patients are surprised when they see their before pictures, that is just the way the human mind works.

I agree on waiting 9-12 months before seeking a revision.  Volume replacement with fillers or fat grafting may also improve this situation.

It is unfortunate that a doctor dismisses a patient.  That is a rare case, and it happens more often than it should.  Patients often need someone to listen to them as they can be frightened about procedures they have never had before.  Best of luck, and please let me know if you have any additional questions!

Tampa Facial Plastic Surgeon

Yes, a revision facelift can correct the asymmetry

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Yes. Revision facelifts have increased in incidence because of the exact issues you are dealing with. It is a major part of my practice unfortunately.  Feel free to contact me if you would like a 2nd opinion.

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.1 out of 5 stars 9 reviews

Revision will only work if the problem asymmetry is "skin deep" and does not go to the bone.

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Many pre-existing facial asymmetries are created by underlying bony or nerve issues such as:

  • a cross bite
  • prior dental work
  • differences in the fullness of the underlying mandible or cheek bones.
  • differences in the two halves of the facial skeleton.
  • pre-existing imbalance in nerve function which can come from a prior palsy or injury.
  • etc.

Your surgeon should do an evaluation of the basis of the asymmetry.

Many times I have to explain that the asymmetry will remain after the surgery unless the patient wishes a very invasive technique to rebuild the foundation.

In most cases in that the asymmetry has always been there, the patient will accept the more youthful look without management of the asymmetry.

Dr. Mayl

Fort Lauderdale

Nathan Mayl, MD (retired)
Fort Lauderdale Plastic Surgeon

Facelift Revision for Asymmetry

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It is very difficult to answer your question without seeing you in person and examining you.  It is possible that your facial asymmetry would be improved with injections as opposed to another surgery

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Face Lift

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I recommend you see a Board Certified Plastic Surgeon, and get another opinion.  They can determine if you are a candidate for another procedure at this time, and when another procedure would be wise to perform.

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Revision facelifts

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Asymmetry is common with facial procedures.  First, review of your preop structure may point out that you had more unrecognized asymmetry than you originally noticed, and therefore such differences continue to show after surgery.  These are difficult to overcome, and therefore more surgery may still not get you there.  Two, you have now had two surgeries with resultant/persistent asymmetry as well.  That means your surgeon has had two shots to restore/maintain symmetry.  Kind of like harvesting low hanging fruit, the easy answers have been covered.  Finally, you now have more scar tissue than ever.  Even with precise, gentle surgical technique and uncomplicated healing your body has healed with changes to the anatomy.  Further changes get harder and harder to achieve and predict as the number of surgeries continue to mount.  Seek additional opinions before moving forward with more procedures, and keep an open mind.  More surgeries may not be the answer, or  a modification of technique or approach might serve you better.

Kevin Robertson, MD
Madison Facial Plastic Surgeon
4.7 out of 5 stars 15 reviews

Facelift asymmetric with Right Side and mouth is downward

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Facelift asymmetric with Right Side and mouth is downward. There are ways to lift just this side. It may be that you could use some other procedures to help you. Fat grafting being one. I would really need to see pictures of you to see if there is a significant difference and what to do with it. One thing to remember too is that everybody is asymmetric and that this is not something bad.

Thanks for reading, Dr Young

Philip Young, MD
Bellevue Facial Plastic Surgeon

Asymmetry after facelifting

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Mild asymmetry after face lifting surgery is fairly common in the first few weeks to months after the procedure.  Pronounced asymmetry is not.  Although it is difficult to assess your situation without photos, it is possible that the vectors of pull on the deep layer of tissue on your face may have been misdirected or excessive skin was removed on the "more pulled" side.  Unless this is very severe, it should equalize over time as the skin and underlying tissues relax.  As the usual time for revision is at one year after surgery, I am not sure getting a lot of consultations with other surgeons makes sense at five months other than to try to make a comfortable connection with another surgeon who you might use. Obviously, if you have been "dismissed" by your first surgeon, you will need to get help from another physician for advice and possible revision surgery.  If things are bearable, then I would suggest seeking out someone who has extensive experience in facelift surgery ( a surgeon who does at least 100 facelifts per year)  and with whom you feel comfortable.  Do this around 11-12 months after the last facelift and discuss the options.

Adam D. Stein, MD
Raleigh-Durham Facial Plastic Surgeon
4.7 out of 5 stars 56 reviews

Facelift Revision for Asymmetry?

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Revision can be done if the amount of improvement that can be achieved will make you happy. Communication with the surgeon is very important. I would write down your concerns and discuss these during your consultation.

Mohsen Tavoussi, MD, DO
Orange County Facial Plastic Surgeon

Revision for Asymmetry 5 Months after Facelift

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Asymmetry is not necessrily a fault - you may have been asymmetrical all your life. Wait another 6-8 months  before considering a revision. You can then decide if the potential improvement is worth the time and money.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 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.