Will a second facelift fall again?

Q:

I had a face lift one year ago. It looked good for 4 months then my face fell. When I went back to doctor he suggested that I have a chemical peel. I refused, now he wants to add fillers from liposuction to my lines around my mouth and cheeks. I asked to have another facelift done, but was told it would only fall again. What should I do?

A:

When a facelift procedure is properly selected and done correctly, it should last for much longer than 4 months. The worst I have had was some recurrence after a few years in a significant smoker whom I could not get to stop smoking. Even then, she did not return to anywhere close to her pre-op state. Many people do a "mini facelift" which only tightens the tissue a little bit. This really does not address the main areas of tissue descent. The tissues can stretch back easily and usually do. I suggest you obtain your operative report from the procedure you had and take it with you when you see a board certified plastic surgeon who specializes in facial rejuvenation surgically as well as non-surgically.

A:

A facelift, in properly selected patients, which includes suture suspension of the deep layers (the SMAS ) in a vertical direction and also vertical lifting of the skin should give a good correction for 5-7 years, longer in patients with good elastic skin and perhaps shorter in patients with poor elasticity from smoking or extensive sun damage.  4 months is an unusually short time to return to your pre operative appearance.  If you have addressed this with your plastic surgeon and are getting no resolution, take your records and have other consultations with board certified plastic surgeons.  The records will enable the new surgeons to see what has been done and possibly offer corrective measures.

A:

Successful Secondary Facelift- A secondary facelift, if done correctly, to restore a natural youthful look using a “Lift and Fill” facelift with central compartment fat restoration and a lateral SMAS technique, you can have an excellent result. This should be done in the hands of a Board Certified Plastic Surgeon with expertise in facial rejuvenation.  

A:

A good SMAS facelift should not fall in 4 months but when the swelling comes down it will look different.  A good secondary facelift may correct your issue and possible fat injections for volume replacement. Photos would be helpful but you may seek a second opinion.

A:

I would suggest that you obtain your operative record and seek a second opinion with an experienced board certified Plastic Surgeon with an excellent reputation in facelift surgery.

My guess is that your deep tissues, the SMAS layer was not adequately tightened and you may have had a "skin only" facelift with minimal undermining. A chemical peel will not correct a failed facelift.

Generally speaking I would expect a well done SMAS facelift to look very good 7 years or more. Failure at 4 months is unusual and should not occur. I would be wary of having the same surgeon attempt a revision or other treatments unless there is a very good reason for failure such as a bleed or other complication.

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