What exactly is "poor quality skin"?

This is a great question and I'm sure one that many patients have.  Skin quality can be compromised by many things including weight gain and loss, sun damage, pregnancy, and age.  Some patients genetically are predisposed to poor skin quality.  Poor skin quality refers to skin that has lost elasticity and appears to be loose, crepey, and/or have stretch marks.  This type of skin does not have the ability to "snap back" once stretched out.  While procedures can be done to remove the loose skin, it will always be more susceptible to stretching again and your results may tend to have less longevity than a patient with good quality, elastic skin.  Once the excess skin is removed surgically, you can have laser treatments to help improve the surface texture.

When that comment was made to you it was probably used to mean a loss of elasticity of the skin.This of course happens to everyone as a normal part of the aging process, but the changes can be more significant in some patients due to a combination of genetics and environmental factors (excess sun exposure, smoking, etc).  The problem that this presents with facelift surgery is that there is an increased amount of relaxation of the skin and underlying tissues after surgery has been done.  You can lift, reposition, support, tighten, etc, etc, etc all you want, but that does not stop the fact that there will inevitably be tissue relaxation after surgery.Again, this happens with all patients, but in someone who has much more loss of elasticity than the average patient you must know how that impacts the healing after surgery and how it adds a few limitations to what can reasonably accomplished.  Patients in this category also have a higher likelihood of needing an early "tuck-up" or retightening procedure.

Poor quality skin, in terms of a facelift, is skin that has lost elasticity due to age and/or other factors, such as smoking or extreme weight gain and loss. Unfortunately, once your skin has lost elasticity, improving its quality is quite difficult. In my opinion, your facial plastic surgeon should have alerted you to the quality of your skin before your procedure, so you could adjust your expectations.
While the skin can be tightened and the excess removed in a facelift, if the skin is thin and inelastic, it won’t hold its shape as well. I’d recommend fat grafting to give your face more volume and pick up some of the slack. You might also be able to improve the quality of your skin and restore elasticity with chemical peels or laser therapy. Medical grade skin care is important, too, but it will not restore elasticity. I hope this helps.