Revision or secondary facelifts include anyone who has undergone a prior facial procedure.
Dr. Gordon is considered one of the leading international experts on revision rhytidectomy as it makes up over a third of Dr. Gordon’s practice. Despite his avoidant approach to the media, he was featured in “W Magazine” (The Movie Issue, February 2011) and noted as a “revisionist who is widely admired for his ability to restore a soft and natural look to an overstretched face and over pulled brows.” The proof of the power of Vertical Platysma Advancement or Deep-Plane Rhytidectomy and its correct anatomical approach is revealed in these cases.
In the majority of revision cases where someone has had a facelift, the procedure was a SMAS procedure that focuses on the surface layers of the face, whether the outcome was pleasing or suboptimal. Since Vertical Platysma Advancements and Deep-Plane Rhytidectomy do not require the skin to be pulled to achieve the desired result, Dr. Gordon only utilizes these techniques to revise previously performed facelifts. The importance here is that having one’s skin pulled is the reason for the unwanted “over-done” or “plastic look” after a facelift. Not only does the Deep Plane or Vertical Platysma Advancement procedure avoid this, but often can fully reverse the “done” appearance. In cases where the first procedure was satisfactory, the current problems are due to the unapproached underbelly layer, and retightening the surface again (a repeat SMAS lift) would not produce a natural result.
In situations where only facial filler and /or fat injections has been used the face is often heavy, bloated, and distorted appearing, while still being loose and droopy. Dr. Gordon has developed techniques which uniquely enable him to not only provide a natural rejuvenation but also allow, because of unique access points, the facial filler and/or fat injections to be adjusted or removed as necessary to optimize the outcome.
Here is the Illusion of Volume Loss video.
Revision procedures are usually one of these situations:
- Well done, satisfying work that has naturally aged. (Common)
- Sub-optimal procedures, usually fall into two categories
- Overdone, over pulled, distortions, visible scars.
- Underdone and imbalanced, visible scars but the inadequate result still left with jowling and/or neck laxity. Facial fillers are also often used to mask this. (Very common)
- Normal aged face- facial filler and/or fat injected instead of receiving gravity reversal procedure-trying to avoid surgery. Heavy, bloated often distorted with a droopy face not treated. (Common)
Most important, because this technique focuses on the deeper facial structure, there is never any unnatural tightening or pulling of the facial skin that typifies older and obsolete facelift techniques. The Deep-Plane Facelift is the most sophisticated procedure available today and studies have shown that it is the most effective procedure available for repositioning sagging soft tissue. That is why it has won the devotion of patients and acclaim from the plastic surgery community.
Because of his expertise in facial rejuvenation procedures that do not create a tight or pulled look by using a unique layer, Dr. Gordon acquired a national reputation as the expert in not only primary, or first facelift, but also revision procedures and was featured in “W Magazine” (The Move Issue, February 2011) and noted as a “revisionist who is widely admired for his ability to restore a soft and natural look to an overstretched face and over pulled brows.
In the majority of revision cases where someone has had a facelift, the procedure was a SMAS procedure that focuses on the surface layers of the face, whether the outcome was pleasing or suboptimal. Since Vertical Platysma Advancements and Deep-Plane Rhytidectomy do not require the skin to be pulled to achieve the desired result, this is the only technique that should be used to revise previously performed facelifts. The importance here is that having one’s skin pulled is the reason for the unwanted “over-done” or “plastic look” after a facelift. Not only does the Deep Plane or Vertical Platysma Advancement procedure avoid this, but often can fully reverse the “done” appearance. In cases where the first procedure was satisfactory, the current problems are due to the unapproached underbelly layer and retightening the surface again (a repeat SMAS lift) would not produce a natural result.
Since the soft tissue of the face has the same anatomy as a sandwich, we use a peanut butter and jelly sandwich as an example. Watch Video Here. A SMAS procedure only moves the top bread of the sandwich, which is why in undesirable outcomes they can have the dichotomy of a tight surface, with obvious scars, yet with jowls and a lax neck needing a facelift. This is because the peanut butter and jelly and bottom bread have not been touched and surface tension is created by tightening the top bread.
The deep-plane procedure takes advantage that a sandwich is a biomechanical unit, it acts as one object, so keeping the sandwich together and only using the bottom bread of the sandwich to move the entire soft tissue unit accomplishes many beneficial things.
- Tension can be removed from the surface, the visible top bread layer, and transferred to the invisible deep bottom bread. Allowing suboptimal scars to be fixed.
- Soft tissue redundancy, evidenced by the fact that jowls and neck changes exist despite a previous facelift, is isolated to the underbelly layer which wasn’t touched but now can be utilized, redoing the facelift.
- Avoidance of retightening the same superficial layer twice, which occurs when a SMAS procedure is used to revise a past SMAS procedure, regardless of whether the initial procedure was satisfactory or not. If a SMAS is used to revise a past SMAS facelift either a done facelift appearance can be created or the procedure will fail to produce a result, since it is the bottom virgin layer that is causing the aging appearance.
- The ability to see and treat suboptimal fat injections or filler injections, string-facelifts or other past treatments.
Why Choose Dr. Neil A. Gordon
Dr. Gordon is considered one of the leading international experts on revision rhytidectomy as it makes up over a third of Dr. Gordon’s practice.
Because of his expertise in facial rejuvenation procedures that do not create a tight or pulled look by using a unique layer, Dr. Gordon acquired a national reputation as the expert in not only primary, or first facelift, but also revision procedures and was featured in “W Magazine” (The Move Issue, February 2011) and noted as a “revisionist who is widely admired for his ability to restore a soft and natural look to an overstretched face and over pulled brows.