Are Revision Facelift and Neck Lift Surgeries Common?

I had a face and neck lift 5 months ago. There is still laxity in the neck area which is concerning and disappointing. Is it true that sometimes a surgeon can only take up so much laxity the first time and that revisions are sometimes needed to achieve the desired results? What is the suggested time to wait? Thank you.

Doctor Answers 35

Facelift revision

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It is true that in some cases a patient will need a second facelift to get the optimal result.  Going back to surgery and having things re-tightened is occasionally required but you should wait about a year before having this done.

San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

Skin still lax after a facelift

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A picture is worth a thousand words, so in absence of before/after pictures I'll do my best.

There is a delicate balance between too tight and not tight enough when performing a facelift. 

  • Not tight enough and there is some residual laxity and the patient may be unhappy
  • Too tight and the patient looks scared and they are definitely unhappy

No surgeon can do with a knife what a patient can do with their hands... A patient can pull the skin up and it looks so easy and wonderful. In surgery, all the pull is at the margin of the ear and back of the neck... as you move more toward the midline, the pulling effect gets less and less... unfortunately, those are the areas that most patients are looking to improve. 

Often there can be complimentary procedures to help tighten some of the residual areas, depending on the degree of laxity. A chemical peel or laser resurfacing are two reasonable options. Before considering revisional surgery, I prefer to give the skin up to a year to completely finish healing and show me its final result

Facelift Revisions

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The most frequent request for facelift revision for people who come to see me after a disappointing result from a facelift is too much fat being removed during facelift surgery. This can leave people looking too tight, hollowed and often older than they looked before a facelift. This kind of result can definitely be improved by structural fat grafting.  I urge prospective patients to look at many before and after images as evidence of the expertise of the plastic surgeon they choose. 

There are some cases when a facelift might require a revision, or a follow up. If a person has very, very poor skin quality due to years of smoking, sun exposure and / or significant weight loss, the integrity of the skin can be compromised. These are issues your plastic surgeon should discuss with a patient PRIOR to surgery, so a person with compromised skin will understand that there may be some laxity soon after surgery is performed.  In these situations, the result of a facelift may look great soon after surgery but the ideal result may not last because of the poor condition of the skin. In these cases, patients may still be very happy with the improvement, but they might hope for a long term result like they experienced soon after surgery.  In these cases, a revision surgery, much less involved than the initial surgery can be performed. 

However, for most patients with good skin quality and normal aging, the result of a facelift should be lasting and very satisfying.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

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Revision Facelift Surgery

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Unfortunately, every Facial Plastic Surgical procedure carries with it the possibility of revision.  At the same time, revision surgery, especially for Facelift, should be relatively rare; a low revision rate (1-5%) is typical of an experienced Facelift Surgeon who take the time to understand an individual patient's concerns and expectations.  The possibility of revision increases when a patient is overweight, or has a very heavy neck.  The classic timing for revision is about a year, by can vary based on the circumstance. The best place to start is with a frank discussion about your concerns with the Surgeon who performed the procedure.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 103 reviews

Revision Facelift and Neck Lift are not common, but sometimes necessary to remove excess neck skin

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A revision of a Facelift and or Neck Lift is occaisionally necessary, but not usual.

The most common revision is the neck.

Sometimes the lax neck skin cannot be totally tightened even with an excellent Neck Lift and Platysmaplasty. In these cases a revision is necessary and usually involves a local procedure which includes excision and removal of excess neck skin with a visible external incsion on the neck beneath the chin.

If a good complete Facelift and Neck Lift have been done and lax skin persists on the neck, local excision is required. It is not done at the time of the original surgery in the hope that an external incision will not be required.

Facelift revisions

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It really depends what was actually done during your "facelift"-whether just skin was removed or different layer lift was used. In most cases you really do get what you pay for. I would suspect that you had a quickie type removal of skin from one of the centers that advertise extensively. However, all surgeries do cause swelling and you look better usually for first several months and then when the swelling goes down, some of the lines, skin returns. This is actually the direct opposite of the "facelifts" that are the quickie lifts for because not much is done, there is minimal bruising and swelling and you look better right away but it usually quickly returns to a large part what you were before you spent your $4500!

Edward J. Domanskis, MD
Newport Beach Plastic Surgeon
4.5 out of 5 stars 28 reviews

Facelift Revision

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As with all plastic surgeries, a facelift and a neck lift procedure both carry the possibility of a revision–either due to undesired results. Although a revision lifts are not considered uncommon, they are also not routine. However wounded tissue heals in stages, so it is important to give the face and neck sufficient time to repair and regenerate. A revision should not be considered until at least 6-12 months post-procedure.

Facelift and Neck lift revisions

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There are two things to know about the neck. One is that it is never as good of a result as the face since the neck is like the knees and elbows (hinge) that change looseness with position.

The second point is knowing exactly what technique was used for the neck lift since frequently the technique used dictates the final result.

Sam T. Hamra, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 15 reviews

Revison face lift

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Sometimes a revision is necessary because there is residual laxity in the neck or cheeks.  Probaqbly happens in less than 5%.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Revision surgery after facelift.

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At five months you should be seeing an excellent result not thinking of a revision. Without a picture to see where you started it is hard to be specific about your degree of laxity. I would recommend you discuss this with the surgeon who did the surgery and see what he/she recommends. I normally do not re operate on face lifts for a full year to let everything settle down unless there was a clear mistake made and I feel it can be corrected. This shortens the time period the patient has to endure a bad result.

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
4.8 out of 5 stars 116 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.