Will a second facelift fall again?
I had a face lift one year ago. It looked good for 4 months then my face fell. When I went back to doctor he suggested that I have a chemical peel. I refused, now he wants to add fillers from liposuction to my lines around my mouth and cheeks. I asked to have another facelift done, but was told it would only fall again. What should I do?
There are a number of reasons that the skin will fall again after a facelift. The most common is that the patient is a smoker with very poor skin or the initial facelift is a procedure that really does not correct the problem. In smokers, the skin rarely returns to a fallen state in 4 months. There are a number of physicians doing facelifts who do a very limited procedure so they can do it quickly and under local anesthesia. Others try to prevent any problems, so the dissection is limited. In these, if you pull the SMAS or skin near the ear tightly, you create a really good initial result. However, you have done nothing to really hold the tissues in place and they rapidly stretch back to their original position. Secondary facelift is a much harder procedure than a primary one. Not only are you are trying to correct the primary problem, you are correcting the problems created by the first procedure and what happened when the tissues stretched and you are doing it in a scarred area. See another plastic surgeon (you can find one on this site) who specializes in redo facelifts.
A good SMAS facelift should not fall in 4 months but when the swelling comes down it will look different. A good secondary facelift may correct your issue and possible fat injections for volume replacement. Photos would be helpful but you may seek a second opinion.
I would suggest that you obtain your operative record and seek a second opinion with an experienced board certified Plastic Surgeon with an excellent reputation in facelift surgery.
My guess is that your deep tissues, the SMAS layer was not adequately tightened and you may have had a "skin only" facelift with minimal undermining. A chemical peel will not correct a failed facelift.
Generally speaking I would expect a well done SMAS facelift to look very good 7 years or more. Failure at 4 months is unusual and should not occur. I would be wary of having the same surgeon attempt a revision or other treatments unless there is a very good reason for failure such as a bleed or other complication.
Successful Secondary Facelift - A secondary facelift, if done correctly, to restore a natural youthful look using a “Lift and Fill” facelift with central compartment fat restoration and a lateral SMAS technique, you can have an excellent result. This should be done in the hands of a Board Certified Plastic Surgeon with expertise in facial rejuvenation.