Revision Facelift and Neck Lift

Abstract

Facial rejuvenation procedures have become more commonly performed due to an increasing elderly population and greater general public acceptance. As a result, patients are now increasingly undergoing secondary and tertiary rhytidectomies to treat natural aging and/or to correct complications from prior procedures. Revision face and neck lifts are more complex by nature of the procedure and require a comprehensive preoperative assessment for enhanced outcomes. In this review, we discuss the preoperative evaluation, surgical challenges encountered, primary face and neck lift deformities, and their surgical management for patients undergoing secondary face and neck lifts.

Use of Biologic Agents for Lip and Cheek Reconstruction

“…Patients who have a history of prior surgery of the face and neck may be less amenable to reconstruction using local and regional flaps due to previous scarring of the facial planes. 11 Radiotherapy, on the other hand, can limit the viability of biologic wound agents and skin grafting techniques by inducing fibrotic changes to the wound bed. 12 13…”

“…Patients who have a history of prior surgery of the face and neck may be less amenable to reconstruction using local and regional flaps due to previous scarring of the facial planes. 11 Radiotherapy, on the other hand, can limit the viability of biologic wound agents and skin grafting techniques by inducing fibrotic changes to the wound bed. 12,13 Lastly it is highly important to elucidate patient's desires and expectations regarding reconstruction and to provide information regarding potential reconstructive options.…”

Revision Rhytidectomy: Pearls and Pitfalls

“…This is attributable to the older age of the patients (approximately 10 years on average) in comparison to the time of the primary procedure as well as changes related to the primary surgery. 23,24 It is important for facelift surgeons to consider vascular compromise as a potential risk when performing revision rhytidectomy. In cases of previous aggressive surgery or liposuction, the neck skin can be irregular, poor quality, and tethered to underlying tissues.…”

“…This is corrected by suspension of the SMAS in a more superior trajectory during the revision rhytidectomy. 24,46 The cross-cheek depression or "joker line" is another deformity that usually occurs in patients with prominent malar bones and submalar hollowing. This can be surgically corrected with a more lateral vector pull during the revision rhytidectomy or fat grafting to the area of depression.…”

“…This is corrected by suspension of the SMAS in a more superior trajectory during the revision rhytidectomy. 24,46 The cross-cheek depression or "joker line" is another deformity that usually This article is protected by copyright. All rights reserved.…”