PLASTICPEDIA
 Revision Facelift
Redo facelift surgery, also known as revision facelift surgery, is when a patient has had a previous facelift surgery and is seeking additional surgery. There can be several reasons why the patient is seeking additional surgery.
Lack of a result
Many patients seeking revision surgery wish to have a more impactful surgery. The goal in facelift surgery is improvement and not perfection, however some changes may be a result of improper selection of facelift technique for the resulting aesthetic problem. Some changes patients wish to attribute to a facelift may not be possible to address. For example, fine lines of the skin are most often a result of skin aging and skin damage from the sun. Simply pulling the skin backwards will not correct this and a skin resurfacing procedure is recommend in addition to the facelift.
Facial Scars
The original surgery may have left wide, unsightly scars. Surgery which relies on excessive skin tension can result on wider, raised scars. Some patients may have a tendency to form wider scars based on their healing characteristics. Some of these patients will have a propensity to form keloids or hypertrophic scars. Discoloration of facial scars is possible, as a result of excessive sun exposure or the natural healing process.
Patients who are seeking scar revision from a prior lift, may need to resupport the deeper tissue in an effort to allow for more favorable scarring. Some patients may need close followup with a combination of intralesional kenalog injections and application of silicone sheeting.
Hairline Shifts
Hairline shifts can occur from over aggressive primary facelift and inappropriate use of vectors. Recreation of a natural hairline after a large loss of hair is a difficult problem in revision facelift surgery. Occasinally, hair transplantation is needed to cover up portions of bald skin (alopecia).
Earlobe malposition
A "pixie ear", aka satyr ear, is when the earlobe is attached along the face, losing its natural plumpness. There are several techniques to correct a pixie ear including repositioning the deeper tissue.
Persistently Full Neck
Some patients may notice that there neck has excessive fullness to their neck after a previous facelift. This may be a result of normal anatomy such as a low hyoid bone or submandibular glands. However, it is possible that excessive fat deposits are present in the neck. There are several common locations that fat is commonly missed by novice surgeons which improve the neck contour.
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