Will I Need a Revision Facelift and when Can It Be Done? (photo)

I am 6 weeks postop and extrememly disappointed with the results of my facelift. I had a lot of swelling appear a week postop but now most of the swelling and fluid have subsided and I am left with close to the same issue I had prior to surgery. Very lax skin under under my chin. One side of my face looks pretty good while the left side is horrible. My PS said that once all the swelling and fluid was gone the skin should shrink up. I am 53 years old with not a lot of elasicity in my skin.

Doctor Answers 24

Facelift revision

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Although you are only 6 wwekks out, I am not optimistic that the skin ecxess under your chin will contract and smooth out without surgical intervention. In my opinion, you weill need a redraping of the neck skin laterally, behind the ears. Correction of this much skin excess through a midline approach may leave an unacceptable vertical scar. I'm not certain if a true neck lift was also performed with the lower face lift or the the surgeon attempted to correct the excess neck skin through a facelift only. I believe its important to follow with your surgeon and discuss your concerns. In my experience, this extent of residual skin excess does not retract spontaneously.

 


Cambridge Facial Plastic Surgeon

Definitely go back

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It is common after surgery to have some swelling and bruising to the face and generally it takes around 3 months for this to subside and the final results to be seen. However looking at your photo's it is very unusual be left with such loose skin so soon after surgery. In fact, patients feel tighter after surgery especially when they have swelling on board. By 6 weeks the swelling would have subsided and the skin would have relaxed from being very tight. It is unlikely that the skin in your photo's is going to shrink back and it may suggest that not enough tightening was done in the first instance and your surgeon was very conservative.

Most surgeons would wait 3 months before being able to assess your face fully but revision surgery can certainly be performed at this stage to tighten the skin and make you look symmetrical.

You should discuss your concerns with your PS and a good one would be able to accommodate you and help you reach you desired goal.

All the best and hope it works out. You can see some before an after photo's on our website for great results on face lifts

When to have a facelift revision

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Swelling after a facelift can take weeks to resolve.  The swelling that others can see usually resolves in 2-3 weeks but swelling that you see or feel will take several weeks.  Based on the photos however I believe some of the skin will still contract but I don't think all of it will.  At 4-6 months, if the results are significantly better, talk to your plastic surgeon about a revision at the 12 month mark.

Mike Majmundar, MD
Atlanta Facial Plastic Surgeon
4.5 out of 5 stars 50 reviews

Revision face lift

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Many factors must be considered before your deciding on a revision faceliftl 
6 weeks is clearly to early since  reduced swelling and skin contraction is to be expected over the next 3-4 months. Those patients with poorly elastic skin can expect  some stretch relaxation postoperatively and the design of the incision may minimize skin redundancy in the lower neck. A frank discussion with the patient  preoperatively mentioning the possible need for a touch up revision will often allay disappointments in the early postoperative  period. Patience is important for both you and the plastic surgeon.

Michael Eisemann M.D.
Plastic Surgeon
Houston

6 weeks post op and not happy after a face lift

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I see all the skin in your neck. That would be pretty hard to see that get taken up with some extra healing. Usually you should have pretty tight neck around 6 weeks time and it will only get more loose with time. You might need a revision. If there is fluid in there I would suck it out and apply more pressure dressings but I think it looks like extra skin. Don't worry though this can be changed for you.

Philip Young, MD
Bellevue Facial Plastic Surgeon

Facelift - Will I Need a Revision Facelift and when Can It Be Done?

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It's hard to say from the photos alone and, of course, each result can reasonably only be judged when compared with the pre-op appearance.  That being said, if there is still skin remaining after your surgery (as appears to be the case) you may well benefit from a revision.  The timing depends on exactly what was done.  Did the surgeon lift up the skin all the way across the neck?  Was it a SMAS only?  These are questions that need to be answered before deciding to intervene again.  Even then, there are few absolutes in terms of timing and what needs to be done, but that's where you'll need to start.

I hope that this helps and good luck,

Dr. E

A revision may be necessary

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Sorry to hear of your issues.  Looking at your photos that excess skin below your jawline is not just swelling- it is excess skin that needs to be addressed with another procedure.  I know it is difficult to be patient, but the longer you can wait (at least six months) the better your results will be.  

Good luck and let us know how things go.

Robert Steely, MD, FACS
Houston Plastic Surgeon
4.8 out of 5 stars 62 reviews

Will a revision procedure be necessary after my neck lift?

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Many thanks for posting your question and photographs.

At 6-weeks it appears you still have a fair amount of redundant skin below your chin, and I am doubtful whether this is going to improve significantly without a revision procedure.

I would recommend discussing this with your plastic surgeon (or perhaps also getting a second opinion) for further assessment and in-person analysis. Further planning can then be made with you as required.

Good luck with taking things forwards

Facelift and Revision

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This is a good question.  Looking at your photographs, it appears as if you neck had very little work done at the time of your surgery.  The neck is extremely important and should not be overlooked at the tike of your facelift.  It is directly related to the pull of the face and needs to be addressed at that time.  The laxity you see in the photos can be corrected and should be corrected.  Since your surgery was only 6 weeks ago, it may improve.  I always like to say, what you have on the table, is what you get afterwards.  It is still too early to predict you result. 

I always say, your face is your diamond, polish it well, so your brilliance will shine.

Walton Montegut, MD
Newport Beach Physician
4.9 out of 5 stars 47 reviews

Early laxity after a facelift

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Submental fullness is not unusual after a facelift depending on the technique used.  However, if there is significant skin excess, it is likely that this will need to be addressed with some technique, likely revision tuck up or skin contracture technique.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 177 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.