Revision Facelift, A Fading or Unsatisfactory Facelift

Revision facelifts are procedures performed after a person has already had a facelift, or has had some other facial procedure – such as injectables or implants. There are many reasons people seek revision facelifts. Often, the person has had a successful facelift which has naturally aged over time and wants further rejuvenation by having a second facelift. The happier you are after your first facelift procedure, the more likely you will want to maintain those results. For all second procedures it is imperative that one understands the importance of how a second facelift, must be performed.

In other circumstances, a person has had a facelift and the result was less than optimal and not acceptable to the individual. Most commonly, procedures that are too conservative, or are imbalanced, undertreat areas such jowls or neck laxity, or create noticeable differences between untreated regions, such as facelifts without brow lifts and result in dissatisfaction. Isolated procedures, such as a neck lift, are rarely effective and do not meet expectations. An isolated neck lift cannot be effective because what we see as changes to our neck are due to drooping facial soft tissue and muscle from our face, so only approaching the neck will not treat the real cause of a loose neck ( facing the mirror, pull on your face and see your neck pull up at the same time). The largest change in revision facelifts has been from the inappropriate use of “short cut techniques” and injectables. Ironically, people using these procedures to avoid “looking done” are creating more problems than they are fixing. Facial rejuvenation procedures must match the stage and degree of facial aging a person presents at the time they are seeking treatment in order to look natural and balanced.

Procedures that do not last as long as anticipated are also a common reason a person will inquire about a revision facelift Patients who have “mini lifts” when their aging changes are well established and far beyond the “mini lift” stage, often end up with inadequate results that last only a short time, creating dissatisfaction. Since gravity’s effects on the facial soft tissues is the cause of our facial aging changes (we get a stretched out face), once facial changes are established, the overuse of facial injections very often makes the problem worse. Over inflated, but yet drooping faces, are a common reason for dissatisfaction. The Deep-Plane technique can access those excessive fillers and provide the necessary repositioning of the stretched out drooping face and neck.

Superficial SMAS lifts that try to achieve a greater result than the procedure can accomplish, or short cut facelift procedures such as “thread lifts”, “mini lifts”, “weekend facelifts”, S-lifts”, especially in patients over 50, can end up producing tight skin, unsightly scars and ear distortions and leave deeper tissue structures, such as jowls, nasolabial folds (folds around your mouth) and neck sag, undertreated. Overdone and underdone at the same time. Results such as this can be very frustrating to the patient.

Obviously, patients who are overdone, with either a pulled or stretched appearance, due to excessive tightness on the skin, tend to be dissatisfied and will seek a corrective revision facelift procedure. A facelift technique that places excessive tightness on the skin can produce poor scarring and distortions around the ears and hair line. This excessive skin tightening from the original procedure can be corrected by the Deep- Plane technique which addresses the underlying structures to relieve excessive skin tension. Scar revision alone will produce greater tension on the new scar and cause a worse resultant scar and should be avoided. In these situations, revising the facelift with a Deep-Plane facelift will produce extra soft tissue that will allow the old scars to be removed and new incision lines created without any tension, thus fixing the poor, unattractive and revealing scars.

Even though it is important to understand the difference between the Deep-Plane facelift technique and others for primary or first procedures, it is essential in revision procedures.

For the large group of people who have had a successful facelift and are seeking further rejuvenation, usually the first facelift was a SMAS procedure. Even with a successful outcome, a SMAS procedure only concentrates on the superficial facial tissue layers. It is important to understand that any further facelift procedure must concentrate on the sagging deeper tissue that has not been addressed by the original SMAS facelift. Repeating a SMAS facelift with another SMAS facelift RE-TIGHTENS the same layer that has already been tightened, which can lead to a ”done” look while still not addressing the loose and sagging deep tissue. Since the DEEP- PLANE FACELIFT technique does not pull on the skin and is directed at sagging deep tissue, it is the BEST procedure for a SECOND FACELIFT and will not produce any further tightening of the already tightened skin layer.

Dr. Neil A. Gordon is not only an expert in primary or first facelifts, but is recognized for his skill in revision, or secondary facelifts using the Deep-Plane technique. Because of his ability to help these patients, Dr. Gordon has acquired a national reputation as an expert in revision procedures. Recently, Dr. Gordon was featured in W MAGAZINE (THE MOVIE ISSUE FEBRUARY 2011) and described as a “Revisionist who is widely admired for his ability to restore a soft, natural look to an overstretched face and over pulled brows”. Only two surgeons were noted in this prestigious publication as international experts in revision facelifts.

Recently, Dr. Gordon has again been invited to present the prestigious MASTER’S SEMINAR on REVISION RHYTEDECTOMY (facelifts) at the annual meeting of THE AMERICAN ACADEMY OF FACIAL PLASTIC AND RECONSTRUCTIVE SURGERY.

Because of his nationally recognized expertise, Dr. Gordon has been appointed to the position of Director, Head and Neck Aesthetic Surgery at Yale School of Medicine, which he adds to his existing responsibilities at Yale of Coordinator, Residency Education in Facial Plastic and Reconstructive Surgery and Clinical Professor of Surgery.

In conclusion, because old fashioned facelifts often produced an unnatural appearance, many people have sought out short-cut procedures or injections to solve their facial aging issues. Ironically, it is not the overdone facelift that seeks revision procedures as much as people with undertreated loose facial tissue or faces that are injected with surface fillers instead of surgically lifted. Whether undertreated, over pulled or that time has gone by, the Deep-Plane facelift technique provides the best solution in all these revision situations.