My Second Face Lift in 20 Years?

   If the first surgeon did a good job with the dissection and the flaps were dissected uniformly, the revision is easier as the plane is already created.  I did a seventh facelift on a woman and found it to be no challenge whatsoever.  Find a plastic surgeon with ELITE credentials who performs hundreds of facelifts, facelift revisions, and facial procedures each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

During your #consultation, your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect. The best procedure approach will be discussed in greater detail during your one-on-one #consultation. 

If you learn that you are a candidate, this may be helpful. Patients who desire facial rejuvenation that is affordable, quick, and effective should consider the Lite-lift™. Like the Life-Style™ facelift, this is a modified facelift that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques that are discussed below. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.Lite Lift™ surgery is individualized for each patient. The best candidates for #LiteLift are non-smoking patients 35-60 years old with early changes of the lower face and the neck. Candidates should also have a face and neck line beginning to sag, but skin with elasticity and well-defined bone structure. Older patients who cannot or do not wish to have a longer operation or general anesthetic can be improved with a Lite Lift™. 

If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives. It is extremely important to seek a board certified plastic surgeon highly trained with your desired procedures. I also encourage you to look at before and after photos of the surgeons actual patients. Also, reading patient reviews of those who have had combined surgeries will be beneficial. Gat

Getting a second facelift is, in general, easier to perform if the previous surgery was an easy experience and there were no complications.  The dissection plane, or where the skin is separated from the underlying tissue, has already been created making it easier to dissect off the second time.  If it's been 20 years, you can also improve the scars and hairloss or deformities created at the time of the first facelift.  Nerve injury is probably the only thing that can't be corrected if present.  

These procedures are not necessarily that much more difficult technically, however they are a bit more risky, as one can never be sure what was done with the facial nerve in the prior surgery.  Careful technique, and often going a bit more conservatively on the actual deep tissue work is usually required to assure no complications.

I don't agree that a second facelift is harder to perform then the first.  I have done hundreds of secondary facelifts.  Occasionally, there is some scar tissue that can make the flap elevation somewhat harder, but this has not been a significant issue in my practice.

Secondary facelifts can be more challenging than primary facelifts because one may have some facial asymmetry, mid-facial scarring, or a degree of facial deformity depending on the previous procedure. The goal would be to perform the 5 R’s: Resect the scar, Release it, Reshape, Refill, all to Restore the patient to a natural looking face.

In my experience have a secondary facelift isn't necessarily any more difficult for the surgeon compared with the original surgery. If the original surgery was properly performed the dissection planes are often easier to dissect the second time around.

You'll want to find a surgeon who is comfortable doing your surgery so consult with a few to help you find the right surgeon.

After having a preliminary facellift, the revision facelift is often difficult, due to built up scar tissue from the previous surgery.  To further clarify, during an initial facelift the SMAS (Superficial Muscular Aponeurotic System) is tightened, and the skin elevated, resulting in a firmer, tauter, appearance of the face.  However, the normal healing process of the dissection plane results in the formation of scar tissue.  Therefore, during a revision facelift the dissection plane, SMAS, can be submerged below layers of scar tissue, making it problematic for the surgeon to find.  However, revision facelifts are common, but it is in your best interest to follow the advise of your plastic surgeon.  If your first surgery went smoothly the first time around, producing only small amounts of scar tissue, most likely your revision facelift will go smoothly as well.  Best of luck!

Any reoperation encounters scar tissue not present with a first-time operation. After 20 years this should be very minimal and you should get an excellent result from a facelift performed by someone skilled in the operation.

  Theoretically, when operating in a field where there was previous surgery, there could be scar tissue and increased bleeding.  But, as you can see from the other doctors who replied, this is not always the case and frequently, second (and third, etc) procedures can be accomplished as easily as primary facelifts. 

It really depends on what was done the first time and what the problems are at the present. Often secondary facelifts are easier. Every case should be tailored to that specific patient so it is impossible to give specifics. Go get some consultations from experienced facelift surgeons.