Patients often present us with revision surgery. That is fixing or repairing a cosmetic surgery that was done by a different doctor. Revision basically conjures up the idea that something is wrong and needs correction. For the most part revision surgery is a result of a less than optimal result. This then is requiring some change to move closer to an acceptable outcome. This principle applies to most all surgeries except the facelift.
The essence of a good facelift requires the cheeks, jowls, and especially the neck to look their best. Scarring and facelift is usually not a problem. The revisions I see are usually a result of the initial procedure being inadequately done – especially in the neck.
Revision Facelift Procedure
Revisions are usually more challenging because of the presence of threads and fillers. As plastic surgeons we are becoming more aware of the fact that fillers and threads are put in place by patients to try to put off what they really need is a cheek and neck lift. The gold standard to treat the aging face is the cheek and neck lift. In conjunction with upper and lower lid blepharoplasty and a brow lift. These procedures when done properly treat the skin, the underlying muscle, and facial fat which can be excess or deficient.
In my practice the primary goal of the cheek and neck or facelift is to tighten the underlying muscle. To achieve the best neck, the dissection must be done deep into the area under the chin, almost down to the collarbones, but not quite. Once the exposure of this anatomy is complete the treatment of the muscle can be properly done as well as the fat above and below this muscle.
Platelet rich fibrin with or without fat treatment can be a good adjunct to restoring the youthfulness of the cheeks and neck. Post procedure we evaluate and often recommend PRF and fillers to achieve the best result for the longest amount of time. As I state before, reversal of the skin muscle and fat must be looked at first before the nonsurgical products and services can be of major benefit.
Revision as I state is usually done to correct or further treat adequately the cheek and neck area. Furthermore, especially the neck which the first time had an inadequate treatment by the original procedure.