What would be the best revision for my face and neck? (Photos)

Please would you advise. I have had a facelift (2012) and two revision surgeries (2013 and 2015) 1st revision was a cut under the chin to tighten the muscles, the second revision was suspending the submandibular glands. Could further surgery make any improvement and what surgery should I look into or are my expectations to high ? Thank you in anticipation.

Doctor Answers 4

Facial contouring #fatgrafting #beauty #tmbcosmeticsurgery #woundhealing #facelift #fillers

Dear kopyto

Thank you for your question and photos! The revision surgery should involve shaping of the deep layer of the tissue ans skin redraping.  You may still see some "sweeping" with tilting you neck down due to changes in skin quality.

With Warm Regards

Trevor M Born MD

Toronto Plastic Surgeon
4.9 out of 5 stars 107 reviews

What would be the best revision for my face and neck? (

My opinion is different. The skin has been pulled tight horizontally. it is loose vertically. I don't think that you can take this amount of skin out in a vertical direction without trading one deformity with another, ie drapery-like sweeps in thecheeks. As you can tell when the neck is extended there is not so much of a problem.

This is largely due to the loss of elasticity of the skin and the strong horizontal pull originally and  subsequent operations. I would be careful about revising this

You can make the submandibular glands better with botox BTW.

Val Lambros, MD, FACS
Newport Beach Plastic Surgeon
5.0 out of 5 stars 8 reviews

Secondary Facelift and Necklift

It looks as if the neck is not fully corrected and the vector of the skin flap pull is off, making you have the wrinkles sweeping up to your cheek in an unnatural way. There seem to still be platysma (neck muscle) bands so you could think about a revision from a board certified plastic surgeon and get platysmaplasty (neck lift) and revision of the neck scar that has skin bunched up by it.  Revision of the facellft could be done with re-direction of the vector of skin pull. Special attention should be paid to the neck rejuvenation-- wide undermining and re-draping of the skin flap after lateral platysma flap is pulled and sutured near your ear.  This creates a much sharper neck and jawline, and really is  a critical factor in the success of a face/necklift which can take years off when you are looking in the mirror!  The skin should not be tight at your incision lines, it is the underlying foundation of your face (called the SMAS) that does all the work and is sutured or lifted more. I usually recommend waiting at least a year before any revision of the face or neck in cosmetic surgery. Good luck to you. 

Face neck revision for the third time

Very sorry. .... you are not my patient, but I am happy to help

We can all make a mistake, even twice. 

Your result illustrates why this work must be performed properly in the first place.It looks like your first operation failed to re-position your facial skin to a higher level. 

One of the most difficult aspects of consultations with patients who have ageing of their neck comes when I tell them that they must also have an incision in front of their ears in order to raise the cheek/jowl skin.

Your revision result clearly shows what happens when the skin is only pulled behind the ears. It does not work. Trying to improve the aging neck without addressing the excess in the jaw line only makes it worse. Patients do not want to hear this. They are frightened by the word "facelift" and much prefer the word "necklift". Your photo clearly shows how your cheek is "hanging" over the edge of your jaw. 

You surely will not want to hear this, but your neck should be redone properly. The good news is that it can be done.

Were you operated on in an office based setting under "twilight" anesthesia? 

Richard Sadove, MD
Gainesville Plastic Surgeon
4.8 out of 5 stars 20 reviews

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