Dr. Lindsey's Newsletter #36: Plastic Surgery By Decade - 70s: The Glamma Era

70s: The Glamma Era and Secondary Facelifts

Father Time and gravity never stop chipping away at our earthly bodies. Because of this no surgical result is permanent. This is something so very important to understand as a patient considering surgery. This isn’t a bad thing, it’s just a fact of nature, but one that must be understood in order to grasp what plastic surgery can do for you. In order to set your expectations when you sign up for your first facelift you must know that your skeleton, muscles, facial fat, and skin will continue to age. A proper facelift will set the clock back on your face and neck. Depending on your anatomy and tissue quality this can be a 10 or 20 year change in your appearance. For the remainder of your life you will have permanently set that clock back in time and you won’t “catch up” to the age on your ID. Despite this permanent change, your tissues will still lose laxity, droop with gravity, and recede in volume. Around 8-10 years after your first facelift you may start getting the itch for a secondary facelift, also commonly referred to as a “revision” facelift. This doesn’t mean that your first facelift didn’t work, it just means it aged and there may be some room for improvement. 

5 Things to Understand About Secondary Facelifts

1. Secondary facelifts are technically challenging - the most predictable facelift is a “virgin face” that has not been operated on, has not been suctioned (a practice that is done but should not be), and has not been injected. For your surgeon it is a challenge to navigate facial anatomy that has been previously altered. This does not mean it isn’t safe or doable, it is just not entirely predictable.
2. The quality of your first facelift impacts the quality of your second facelift - your surgeon will have to navigate changed anatomy whether that was for the better or worse. It is really exciting as a surgeon to open a face and neck that have pristine, beautiful surgical planes. A really well done facelift sets the second surgeon up for success. Unfortunately this is not always the case and a poorly executed first facelift will present challenges and limitations on what a secondary facelift can achieve. 
3. The cost of a secondary facelift is higher - if you understand the first two concepts, this one just makes sense. Fees reflect the time and resources needed to perform a surgery. Revision facelifts often take longer because the surgeon must perform a slow, meticulous dissection through scar. This increases the complexity of the case and therefore the amount of time spent operating. 
4. A secondary facelift is an opportunity for improvement - the results of a secondary facelift can be better than the first. Although technically challenging, as a surgeon I can tell you, I love a challenge. Complex problem solving is a part of plastic surgeon DNA. If you were sold on a “mini facelift” previously and got a “mini result” as we like to call them - your results probably fell far short of excellence. If you faced challenges during the healing process and your body failed in unexpected ways - your results probably fell short in some capacity. A secondary facelift can be an opportunity to approach facial rejuvenation with more knowledge and experience under your belt. The right surgeon can improve on undesired outcomes from your first facelift within the boundaries of what is surgically possible. 
5. The plane may not matter - if you are an avid follower/consumer of the aesthetic industry, “deep plane facelift” means something to you. You probably have a fully formed, rigid opinion, from the hours of deep internet diving on facelift research. I trained at UT Southwestern - the mothership of deep plane, high SMAS facelifts. In my practice, I perform High SMAS Deep Plane Facelifts…. sometimes. I may just blow your mind with my thoughts on the deep plane facelift, but you are going to have to wait until my next newsletter to learn why.

Stay tuned and learn why my approach to the SMAS and plane is more fluid compared to other surgeons …

As always, here's to choosing how we age, on our own terms!