[Eton TV] What Are the Effects of Revision Facelift Surgery?

What Are the effects of revision facelift surgery?

Many people worry that the results after facelift surgery are disappointing.

There are also people who are afraid of revision surgery.

Revision surgery can sometimes bring good results more easily than expected.

So rather than making a quick judgment, I recommend thinking again about whether a better surgical method could help you regain a younger-looking face, and consulting with a specialist.

Revision facelift surgery is completely different from the first surgery.

It can be broadly divided into two cases.

The first is when the initial surgery was not done properly.

The scar is long, but the important 'deep plane' technique was not applied, and only the skin or surrounding tissue was pulled unnaturally.

In such cases, because deep-layer dissection was not done properly, revision surgery can actually be performed more cleanly, just like the first surgery, so it can be easier to operate.

If the first surgery was done incorrectly, revision surgery may actually be easier.

However, if the first surgery was done well and revision surgery is only being done to correct the disappointing parts, that is a different story.

Because the deep plane space has already been dissected once, the tissue becomes adhered and tightly bound, leading to more bleeding and making the surgery much more difficult.

Even doctors feel tremendous pressure when performing revision surgery.

Since it was someone else’s surgery, there are often no accurate records, and the biggest concern is not knowing how far the dissection was done.

Also, as the tissue is pulled after surgery, the positions of normal blood vessels or nerve branches can change.

If that differs from the anatomical structure we are used to, there is a risk of unexpected bleeding or nerve injury.

It feels a bit like disarming a time bomb or handling a black box whose contents are unknown, doesn’t it?

That is why both the psychological and practical difficulty are high.

The first surgery can give the patient a good result, so I feel happy too!

But with revision surgery, it is hard because I do not know what is where, and there is a lot of bleeding.

It also takes much longer.

If the SMAS layer is strong, dissection is easier and the lifted SMAS layer is maintained well.

But if the tissue itself is loose or thinned out, it can tear during fixation,

and even if it is fixed well, it may not last as long as the first surgery and can relapse quickly, so there are many uneasy cases.

Among past surgical histories, two things in particular interfere with surgery and make it dangerous.

The first is 'non-absorbable thread.'

We use only safe, proven absorbable threads, but sometimes unverified or non-absorbable threads have been used.

If those threads remain in the layer where they are useful for pulling— that is, the layer we use in surgery—they can get caught during dissection,

and in the process of removing the thread, normal tissue can also be damaged, so this is the most troublesome case.

The second is repeated energy-based procedures or injection procedures, especially semi-permanent filler or collagen filler procedures.

Some patients keep getting semi-permanent filler injections because absorbable fillers seem to disappear too quickly,

but the filler material can become entangled with the tissue, making dissection quite difficult.

Like facelift revision surgery, there is a lot of bleeding and significant tissue distortion, so this is also very difficult.

Even so, there are situations in which revision surgery is done, or must be done.

When I examine a patient, I predict by feeling the firmness of the soft tissue directly with my hands.

With imaging tests such as ultrasound or MRI, it is difficult to accurately tell how loose or firm the tissue is,

but when I pull it by hand, the difference between the first surgery and revision surgery is clearly felt.

If I understand where the tissue catches and the location of the retaining ligaments, I can predict about 80% of the difficulty and outcome of revision surgery.

About 80% of the time, the situation is one in which additional surgery is helpful because the first surgery was done incorrectly.

Severe cases are less than 20%, so the difficulty of revision surgery is not as high as you might think.

Revision surgery is needed more often than people think.

Many people who undergo revision surgery come because of scars.

Many also come because the lifting effect on the face is insufficient,

but in many cases, they decide on revision surgery because of unsightly scars.

If you simply cut out the scar and sew it closed, the skin is pulled again and the scar becomes thicker,

so in such cases, the entire facelift surgery is redone by pulling all of the deep layers.

One of the characteristics of people whose scars have become thick is the so-called 'knife-shaped ear.'

This is when the ear is pulled downward and lengthened, making it look artificial.

Such knife-shaped ears often occur because deep-layer dissection was not sufficient and the skin did not heal properly,

so they can be corrected relatively easily by separating the tissue and pulling it upward.

Also, in some cases, the lower cheek pad protrudes again quickly after surgery or sags downward. This usually happens when the inside was not fixed well.

Sometimes the tissue itself is weak, but in most cases, if the deep plane method is used and we go deep into the layers and separate all of the retaining ligaments, the problem can be corrected well.

In particular, people who had surgery about 10 years ago often had the classic method, so many of those cases were not done with the deep plane technique. In revision surgery, the effect can be good, and the operation may be relatively straightforward.

If you have revision surgery and then need revision surgery again, recovery takes longer, and the psychological and financial burden becomes very large.

So it is important to visit several clinics, get thorough consultations, and hear explanations about why the face has sagged again and how much improvement can be made, and by what method.

Neither always doing a large operation nor trying to solve everything too simply is good.

Each clinic may be good at different surgical methods, so listen carefully to the full explanation and think of it as the 'final surgery' when making a careful decision.

Thank you.