Can I have a facelift revision with this necrotic skin? (Photo)

Question

I have necrotic skin due to a facelift. It’s been 2 years but the facelift left me worse of than before. I need a revision. A facial surgeon said that it can not be performed because the skin is dead and won’t hold the revision. Can I have a revision with this necrotic skin?

Manish H. Shah, MD, FACS · Answer

Hello Plucky6208,
I'm sorry to hear of your experience. Wound healing issues are a risk of facelift surgery. To help reduce the risk of secondary necrosis or other wound issues during facelift revision, you will want to ensure that the blood supply to that area of skin is maximized after surgery. I usually perform a series of PRP injections to increase local blood supply. I then wait a few months to perform the revision facelift. After surgery, I would recommend both PEMF therapy and hyperbaric oxygen treatments to make sure that skin is babied maximally!
We have all had patients with flap necrosis. I have never had a secondary healing issue on anyone I needed to revise when I take the steps above.
Of course you can't smoke or be around smokers, you have to be well-nourished, and all medical issues have to be under strict control by your primary physician.
I hope this helps?
Dr. Shah

Anil R. Shah, MD · Answer

Hello,

Revising your face is possible, with the goal of addressing the necrotic skin and repositioning it to a safer location. To determine the feasibility of a revision, it's advisable to consult with a skilled facial surgeon. They can assess the skin's laxity and readiness for the procedure.

Jacob Tower, MD · Answer

Hello, hope you are well. The answer to your question depends on how much skin laxity there is in your face. You can absolutely undergo a revision facelift, but if there is not enough healthy skin to mobilize, lift, and re-drape, some scar tissue may still remain. You would need to submit more detailed photos or have an in-person consultation to help you determine what you could reasonably expect from revision surgery.

Best,
Dr. Tower

Best,
Dr. Tower

Gianfranco Frojo, MD · Answer

I do not believe that this will be an issue at all as long as it has been at least 1 year from the initial injury/surgery. I would find a plastic surgeon certified by the American Board of Plastic Surgery. I always tell prospective patients to look at the plastic surgeon's training (ideally a 6 year integrated plastic surgery residency and a 1 year aesthetic fellowship accredited by The Aesthetic Society). In addition, examine before/after photos on social media platforms. I would also look at Google or RealSelf reviews. This will help you get a comprehensive understanding of your provider.

Jeffrey H. Spiegel, MD · Answer

It is certainly possible that much of that scarred skin can be removed, and, it will leave you with a better appearance.  However, we'd want to see an entire photo of your face.

Ronald J. Edelson, MD · Answer

The revision can be done by something called serial excisions. You can have the skin in front of the ear partially cut out, then come back after at least six months and do it again

Connie Hiers, MD, FACS · Answer

No, you need to wait until you have excess skin in that area which can be removed. Scar tissue does not produce excess skin very quickly. If it is tried now, you just may lose more skin and look worse.

Jason Pozner, MD · Answer

I see a lot of patients with post operative issues and can help if you have had healing issues in the past. I have to see you in person to evaluate the tissues.

Darryl J. Blinski, MD · Answer

Based on your two posted photos, only in person or virtual consult would allow a determination if there is enough laxity to try to revise the pre-auricular facial skin. Expected to be from $5000-$10,000. Again in person consult better than virtual.