What is revision facelift

Revision facelift is the terminology for undergoing a facelift after having a previous procedure on your face, including previous facelift or neck lift surgery. The anatomy and soft tissues of the face is intricate, and once surgery has been completed there is a degree of scarring and change in anatomy that is unique to each individual patient. The level of scarring is dependent on multiple factors, including the previous surgery, the surgeon, the ethnicity of the patient and their individual genetics and healing.

The treatment of patients who have undergone previous surgery is more challenging and is dependent on the degree of scarring and patients’ expectations from surgery. Although for most patients, a substantial improvement can be made, the key to success is the achievement of the patient’s expectations. Approximately thirty per cent of Dr De Silva’s patients are revisions surgeries.

Revision Facelift

How do you approach revision facelift?

Facelift or neck lift surgery to fix either the cosmetic defects or improve scarring can be challenging as there are changes in the underlying anatomy and scarring that can be improved, however not reversed. Patients may end up dissatisfied with their end results, and wish to fix their previous surgery, which creates a need for secondary or even multiple surgeries. Revision facelift surgery can be completed to improve the shape and expectations are important to discuss.

Because facelift surgery is a challenging procedure, if the surgeon is not sufficiently skilled or experienced, patients can end up with dissatisfaction with the cosmetic appearance of their face or neck. Revision facelift surgery seeks to solve these problems, and as each case is unique, the techniques used will also vary per patient. That is why it is important to choose a surgeon who has a great deal of technical skill, knowledge of the latest techniques, an artistic touch, and extensive experience, especially with dealing with the patient’s specific ethnic group and problem.

Simpler cases of revision facelift and neck lift surgery will remove some excess loose skin or further tightening of the neck. There are also further limitations on a revision facelift that was not present in an original procedure: scar tissue may have built up to a point where surgery is inadvisable, or the skin in the area may be compromised or insufficient. Revision surgery can be very challenging with a combination of scar tissue and a change in natural anatomy; realistic expectations are an important consideration.

How long does revision facelift take?

Revision facelift surgery is an outpatient procedure and can take between three to five hours.

Recovery time after revision surgery?

Often recovery time is longer with revision surgery as a consequence of increased swelling and scar tissue. After surgery, Dr De Silva uses specialised anti-inflammatory medications to enhance recovery and has pioneered the use of regenerative medicine in the UK.

Revision Facelift

What are common indications for revision facelift?

  • Loose skin, fullness in the neck with deep facial lines, a tired appearance, unsatisfactory scarring amongst others. Most of these complications are modest and can be easily corrected and may occur in the best of hands as a patient’s healing process play an important role in facial surgery.
  • Each revision surgery is unique and requires customised treatment with respect to the underlying changes.

What is different in revision facelift surgery?

  • Revision surgery is a more complex procedure with the presence of scarring and a change in the natural anatomy and often requires additional specialist techniques to improve the aesthetic result.
  • For many patients, Dr De Silva uses combination techniques including fat transfer, chin augmentation, skin resurfacing, to enhance the results.
  • As a consequence of having a previous facial surgery, the recovery after revision surgery can be longer as swelling can longer to resolve, for some patients the use of regenerative medicine after surgery can be a powerful tool to speed up recovery after surgery.
Revision Facelift

Can revision surgery always be completed?

Dr De Silva is able to achieve excellent results in revision surgery and will operate on cases where he feels he can achieve a success that is within the patient expectations, if he cannot achieve this he may advise against further surgery. Dr De Silva asks some patients to send information such as medical history and photographs of their face in advance of a consultation to ensure that we are able to help.

Scarring can generally be improved, however, often requires revision facelift surgery to remove the existing scars and replace with healthy skin. Improvement of scars can be dependent on there being some loose skin to achieve.

Can scars be improved?

Unsatisfactory scars are caused by a combination of factors including surgical technique, the position of scars, closure techniques (stitches vs staples) and genetics (1% of patients can have healing issues with scars secondary to their genetics). Scars can generally be improved by a number of measures:

Surgeon’s technique. Surgeon’s use different techniques to complete a facelift and neck lifting procedure. Meticulous care and attention to detail are required to hide the facelift incisions in natural creases and curves.

Location of the incision. The incision and scars can be hidden by placing the visible portion of the incision inside the ear canal or opening behind the little lump in front of your ear called the tragus.

Multiple-layered meticulous closure. Multiple layered skin closure ensures that there are deep stitches to support the soft tissues once the superficial skin stitches are removed; this is key to avoid unattractive widened scars.

Bevelled incision. In hair-bearing skin, the use of bevelled incisions in the hairline enables hair to grow through the scar after surgery, hiding the scar in hair-bearing skin.

Deep plane face lifting technique. Lifting the deep tissues beneath the skin (SMAS or Deep Muscle Tightening) before skin closure is essential to give a natural-looking result and avoiding tension on the skin.

Stitches. There are different methods that can be used to close the skin. Some surgeons use staples to save time; however, they can leave marks, unsatisfactory scars and are uncomfortable to remove. Dr De Silva avoids the use of staples in all patients as the best healing is from the use of fine sutures in non-hair bearing skin.

Regenerative medicine. Dr De Silva has pioneered developed the use of signature regenerative medicine techniques to enhance scar resolution.

Revision Facelift

I had a difficult recovery after facelift surgery, I am worried about have further surgery…

Many of our patients are anxious with revision surgery; they did not have the result they were looking after the first surgery and are worried about undergoing further treatment. Dr De Silva takes time to ensure we provide a thorough discussion regarding further treatment, recovery and offering emotional support before and after surgery. Our aim is to provide the best possible experience and to foster a long-term relationship with our patients to provide ongoing care for years to come.

Watch Video: Sky News interviews Dr. Julian De Silva about Patient Safety in Cosmetic Surgery
Sky News interviews Dr. Julian De Silva about Patient Safety in Cosmetic Surgery

Will I be happy after revision facelift surgery?

Dr De Silva only provides patients with sincere information on results from revision surgery, and a minority of patients he advises against surgery. Although most patients’ symptoms can be improved substantially, it is important to have a discussion regarding realistic expectations, as the previous scarring cannot be reversed only improved. A small proportion of patients may require two procedures.

What is the worst complication?

After a thorough examination, most serious issues can be excluded (skin necrosis and motor nerve injury). The key aspects are recovery often takes longer with the final result as long as 12-18 months after surgery. In addition, realistic expectations for improvement are important to discuss.

I live abroad, how can I have revision surgery?

Dr De Silva has a large number of revision patients that live overseas. Our specialist team can help you organise virtual consultation and coordinate your trip to the UK. We are able to utilise the latest technology to enhance your recovery, including oxygen therapy and regenerative medicine.

Why come to the UK for revision surgery?

London and Harley Street have been famous for providing world-class medical services since the 19th Century. A combination of the state-of-the-art facilities, stringent safety regulation and international clinicians. Dr De Silva has treated patients from all continents of the globe looking to have the best quality of care in the world.

  • Over 30% of Dr De Silva’s patients have undergone previous surgery.
  • Dr De Silva has completed numerous book chapters and research articles on facelift surgery and revision surgery.
  • Dr De Silva published a book entitled a complete guide to face and neck lift surgery in 2020.
Revision Facelift

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