I had a full Facelift February 2013 with bad results. What Facelift will be good for me after having full Lift already? (photos)
Doctor Answers 18
How your facelift may have regressed, and doing full procedures in the face and neck for optimum results
Initially after a facelift, if there’s improvement of the jawline and the cheek and the neck looks good, chances are you had good results. The results that you are having presently may be a result of regression or relaxation. No matter who does the facelift, how well it’s done or how technically proficient the doctor is, there is always a certain amount of relaxation and elasticity. When you turn your head and move up and down, the skin and the tissue will stretch.
The challenge with face lifting surgery is the sagging of tissue. There are two critical elements which cause the face to sag: one is that the skin gets thinner and stretches as we get older. Second, a deeper layer of muscle that is referred to the platysma or superficial musculoa poneurotic system (SMAS) is affected.
A facelift can mean anything from a short scar limited facelift to a facelift incision which goes from the temple to behind the ear. When we do a face and neck lift in our practice, we extend the incision to behind the ear and into the hair so that we can address the band under the neck as well as the sagging skin. We also typically make a small opening under the chin to do something called a platysmaplasty. So when I look at your photos, I notice the two platysmal bands and I think there’s an opportunity there to do something to enhance the neck definition.
A lot of people also misinterpret what the definition of facelift is. They think that a facelift includes the brows where the incision is made on top, but that is a separate procedure called a browlift. A facelift is defined is done from the temple to lift the cheek and the jawline. In contrast, a neck lift is more for sagging skin. Sometimes, a facelift will address a significant part of the neck depending on how old you are. If you’re a younger patient in your 40s or 50s, sometimes tightening the SMAS with a limited platsymaplasty or release can give you really nice neck definition without making that incision in the back.
As far as the original procedure is concerned, you may want to discuss this with your original surgeon and ask what can be done in order to get the results that you desire. A lot of times, people want a conservative procedure and when they have a 60-70% improvement in the jawline which in consultation they were willing to accept, sometimes they want more and that’s completely understandable. In our consultations, we actually spend a lot of time discussing the details of what is involved to get optimal full correction.
Some patients end up with bad scars, pixie ears and a pulled down appearance when done by some people who do mini or shortcut procedures. I end up doing the full proper face and neck lift regardless of what their operative result states or the information they provide because it just doesn’t make much of difference when we are actually in surgery. The decisions are made in real-time during surgery with some projection and anticipation prior.
It looks like you are probably a candidate for either an enhancement from your prior procedure or a full face and neck lift based on the photos you submitted. The one thing that I can’t do is a do a physical exam to feel how much tension there is and what the realistic expectations would be.
Enough time has certainly passed to allow for tissue swelling and other factors to have resolved. I would recommend that you meet with your original surgeon and see if you can resolve this issue. If that’s not a viable choice for you, meet with additional doctors and consider the options of having a face and neck lift. Avoid shortcut mini procedures - they tend not to work when you have the much platysmal banding and the amount of relative sagging that you demonstrated in your photos. I hope that was helpful, I wish you the best of luck, and thank you for your question.
There is almost never an indication for a mini facelift.
Unsatisfactory face lift result
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Revision facelift for platysma bands in neck
You would get a very good result from doing a revision lower facelift. Specifically you need either a SMASectomy or SMAS plication (for your jawline, jowels and lower face) a platysma flap and midline platysma muscle band plication (to tighten your neck muscles).
This is hard to achieve using short scar facelift or mini facelift incisions and the more traditional facelift incisions including one in the chin crease will be necessary.
I had a full Facelift February 2013 with bad results. What Facelift will be good for me after having full Lift already?
Always seek out the opinion of a surgeon certified by the American Board of Plastic Surgery with years of experience in facelift surgery. Remember this is your face....can't cover it up! Furthermore request to see before and after photos of previous patients by that doctor....not a clinic or surgery center. Do your homework......research and verify the doctor's credentials. Have they had problems with the Board of Medicine, disciplinary or otherwise. Any law suits?
How about the center, clinic or facility? Are they accredited by a national organization or do they just have State approval. Understand that at the current time, there are three nationally recognized organizations responsible for the highest levels of patient safety, AAAASF, AAACH and JCHO. You owe it to yourself to position yourself for the best possible results but under the most stringent safety regulations, If you have kids, even more so.
How about anesthesia? Will you have a medical doctor certified by the American Board of Anesthesiology or a certified nurse anesthetist (CRNA)? Understand that there is no substitute for research. Cosmetic surgery, no matter how simple it may be to the patients, are invasive procedures and as such carry certain risks and complications.
In our office we use TouchMD which is a web based program in which patients have the ability to load their picture unto the program. We accomodate patinets from as far away as California. I then evaluate them and can actually draw on the picture to show a potential patient where the incisions would be located and how the procedure is to be realized. It's all done to comply with HIPPA which is the federal law that protects the patient's medical information. Look them up.
Give yourself the highest percentage of a sucssesful operation. Good luck
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