Are there certain type of facelifts that cannot be up for revision?

If the doctor elevated a smas flap on the first facelift, is a revision not possible and you are stuck with a distorted face?

Doctor Answers 10

SMAS elevation ina revision facelift

It is possible to perform something like an extended-SMAS or deep place facelift when doing a revision even if a SMAS flap was used previously.  It will be a bit more challenging from a technical standpoint, but in many cases it can still be done.

However, it might not be necessary.

Any facelift surgeon who chooses to offer revision or secondary facelift procedures MUST be comfortable with a variety of techniques and be able to shift on the fly to adjust the surgical plan as needed.  I would advise you to seek out a surgeon who focus their practice on facial rejuvenation and facelifts in particular.  It will be helpful for your surgeon to know about your previous procedure and even get a copy of the operative report if possible.


Charleston Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Good question

There is always scope for revision but not all techniques work as well the second time. Also, its worth bearing in mind that the same pathology may not be present the second time. For example the techniques to rejuvenate the neck are different to those to freshen the midface. Please bear in mind however that the older patient will get a great benefit from revision surgery but the tissues may not hold on to that benefit for as long as those of a younger patient. Hope that helps.Adam Goodwin

Facelift revision

Is always an option and possible(you do not have to live with a distorted face).Re-elevating the SMAS is typically not a problem and other techniques can always be performed if there is significant scarring and the SMAS cannot be re-elevated. Adding volume during the revision either in the form of fat or fillers will aid in the revision. Waiting a period of 5-6 months from your first surgery is a reasonable amount of time to wait prior undergoing a revision.

Revision facelift

Revision facelifts, in the right hands, can be just as successful as primary facelifts.  To be honest, it is now more and more common to see secondary and revision facelifts as patients who had their first lift 10+ years ago are starting to come back for their "tuck ups".  During that time, techniques have changed dramatically - from subperiosteal lifts all the way through less invasive, quick stop lifts (like the lifestyle lift which was popularized a few years ago).  Previous elevation of a SMAS flap does not preclude the surgical plan in any way - but it certainly is good to know about as it allows us to modify what is and isn't done during the surgery.  Also, often times if a surgery was done alone, addition of adequate and appropriate volume can aid a revision or secondary lift more than surgery alone.  I hope some of this helps.  Best of luck.

Miguel Mascaro, MD
Delray Beach Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Revision surgery is possible

Revision facelift surgery has very good success no matter what the type of facelift that was performed previously.  Each circumstance is a little different, but elevating or not elevating a SMAS flap will not impede my ability to deliver a great result for facial rejuvenation.  The success with a revision facelift is as high as it is for a first time facelift in my experience.  Expertise and the overall experience of the surgeon will help determine the overall success of a revision facelift. 

David Q. Santos, MD
Bellevue Facial Plastic Surgeon
4.3 out of 5 stars 21 reviews

Is a revision possible

If a SMAS flap was elevated properly, usually it can be elevated again during a revision facelift. Even if it cannot be elevated again, other techniques are still available that can work well. Even if the first procedure was done poorly, often a revision can still be performed with significant improvement.  Likely focusing on volume replacement (ie fat grafting) as well during a second procedure can significantly improve the outcome if this was not done during the first operation.

Dino R. Elyassnia, MD
San Francisco Plastic Surgeon
5.0 out of 5 stars 10 reviews

Facelift revision

Revisions are typically possible. The exact details of what techniques/specific procedures are done to improve the situation vary widely depending on circumstances and surgeon. I typically will not consider revising a facelift until a MINIMU of six months has passed sine the last procedure.

Robert H. Hunsaker, MD
Miami Plastic Surgeon
4.4 out of 5 stars 71 reviews

Types of Facelift Revisions

As a general statement, all sub-par/non-satisfactory facelifts can be revised with some success. Regardless of the actual method used on the initial lift, a revision lift would aim to correct as many imperfections as possible. Many imperfections can be corrected with good success (ie "pixie ears" (pulled earlobes) and wide scarring). Others such as motor nerve injury (nerves that move portions of the face) may not be correctable at times. In my opinion, what is absolutely most important when searching for a surgeon to perform your revision is the number of facelift procedures he/she has performed in their career. There are truly not many "Revision Specialists" for facelifts (unlike Revision Rhinoplasty surgeons, which are more numerous), so you should seek specialized facial surgeons who only focus on the face. In an exclusive facial plastics practice such as ours, probably one out of every 5-7 patients have already had a previous facelift. Therefore, simply by volume, a busy facial plastics doc will have treated significant clients who have had previous work (both good and no-so-good) performed. Hope this has been helpful, and best of luck to you! -Doc L.

Paul Lanfranchi, DO, FAOCO
Las Vegas Facial Plastic Surgeon
4.9 out of 5 stars 53 reviews

Are there certain facelifts that can not be revised?

In most cases, a facelift can be revised to obtain further improvement.  If a SMAS flap was elevated on your first facelift, this would not be considered a reason that a revision could not be performed.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Revision facelift

Usually a revision can be done to improve the result by either adjusting the SMAS layers or redraping and trimming the skin, or both. You have to be seen in person to really have your question answered. Also if the facelift was done recently, revision may be more difficult. Get a number of opinions. 

Sheldon S. Kabaker, MD FACS
San Francisco Facial Plastic Surgeon
4.7 out of 5 stars 28 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.