Revision facelifts or secondary facelifts are procedures done after a person has already had a facelift. There are many reasons people seek revision facelifts. Most often, the person has had a successful facelift and it has naturally aged over time and the person wants further rejuvenation by having a second facelift. The happier you are after your first facelift procedure, the more likely that person will want to maintain their result.
In other circumstances a person has had a facelift and the result was not acceptable to the individual. Most commonly, procedures that undertreated areas such as jowls or neck laxity or are imbalanced, such as facelifts done without browlifts create dissatisfaction. Isolated procedures such as necklifts are rarely effective and often do not meet expectations. Procedures that do not last as long as anticipated are a very common reason a person will inquire about a secondary facelift procedure.
This is the reason that the type of facial rejuvenation procedure should match the stage of facial aging a person presents with when they are seeking treatment. Patients who have minilifts when their aging changes are well established often end up with inadequate results that last only a short time creating dissatisfaction.
Obviously, patients who are overdone with a tight or stretched appearance tend to be dissatisfied and also seek corrective procedures. Any facelift technique that places excessive tightness on the skin can produce scarring and distortions around the ears or hair line problems.
Superficial based facelifts procedures such as minilifts, weekend facelifts, S-lifts and SMAS lifts that try to achieve a greater result than the procedure can accomplish, especially in patients over 50, can end up producing tight skin and poor scars and ear distortions but leave deeper tissue structures such as jowls, nasolabial folds and neck skin undertreated. Results such as this can be very frustrating.
Where it is important to understand the differences between facelifts for primary or first procedures, it is essential in revisions.
For the large group of people who had a successful facelift and are seeking further rejuvenation, usually the first facelift was a SMAS procedure. Since this procedure concentrates on the superficial tissue layers even when it produces a great outcome, it is important to understand that any further rejuvenation procedure must concentrate on the sagging deep tissue that has not been addressed by the original SMAS facelift. Repeating a SMAS facelift with another SMAS facelift retightens the same layer that has already been tightened, which can lead to 'done' look while still not addressing the loose deep tissue. Since a deep-plane facelift does not tighten the skin and is directed at the sagging deep tissue it is the best option for a second facelift without producing any further tightening of the skin layer.
In situations of facelifts that did not produce the desired result, the cause dictates the solution.
Underdone procedures or imbalanced results need the proper treatment plan. Since the inadequate facelift result usually is related to skin tightening with untreated deep tissue, a deep-plane procedure is usually the best option to achieve the originally desired result.
Some people will complain about their scars but be satisfied with their facelift. It is important to recognize that bad scars are always the result of excessive skin tightness. 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 scars created without any tension, thus fixing the poor scars.
There are some people who have received an overly aggressive, tight skin appearance and further procedures, even deep tissue based may not achieve an appropriate improvement. In these cases waiting and not undergoing further procedures is the best advice.
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