A revision deep plane facelift may be considered when an earlier facelift has not achieved the hoped-for result, has relapsed early, or has left problems such as a tight or ‘pulled’ look, visible scars or a distorted earlobe. It is also used for a secondary lift many years after a first operation. Revision is usually planned at least 12 months after the previous surgery and is more complex, because scar tissue alters the anatomy.
Why revision surgery happens
- Early relapse: jowls or neck laxity return within a year or two, sometimes when only the skin was tightened.
- Operated appearance: a wind-swept, flattened or overly tight look from tension on the skin.
- Scar problems: wide, stepped or visible scars, or a shifted hairline or sideburn.
- Earlobe distortion: a lobe pulled downwards and forwards, sometimes called a ‘pixie ear’.
- Residual neck concerns: bands or fullness that were not addressed first time.
- Natural ageing: a secondary lift many years later as the face continues to change.
How long to wait
After any facelift, swelling, firmness and scar tissue continue to settle for many months. Operating too early can make it difficult to judge the true result and increases surgical difficulty. Most surgeons advise waiting at least 12 months before revision, and longer if scars are still immature. The exception is an early complication, such as a haematoma, which is treated urgently and is not considered revision surgery.
What a revision deep plane lift can improve
Because the deep plane approach repositions the deeper tissues rather than relying on skin tension, it can often correct a tight or pulled appearance from an earlier skin-only or SMAS lift. The mid-face can be lifted where it was previously untreated, the jawline redefined and residual neck laxity or bands addressed. Scars can frequently be repositioned or narrowed, and a distorted earlobe can be reset. Fat grafting may be added to restore volume lost with time.
What cannot always be corrected
Revision surgery has limits. Scar tissue restricts how freely the tissues can be moved, and skin that has already been thinned or stretched may not behave as it did originally. A hairline that has been shifted significantly, or hair lost along previous incisions, may not be fully restored. Very thin skin, previous skin healing problems and nerve injury from earlier surgery can limit what is achievable. Mr Nassab will be clear about realistic expectations and whether the likely benefit justifies the additional risk.
Why revision is more complex
The anatomy after a previous facelift is less predictable. Planes that were once easy to separate are bound together by scar tissue, and the facial nerve branches may lie in unexpected positions. This makes surgery longer and more demanding. The risks of haematoma, nerve weakness, skin healing problems and prolonged swelling can be higher, and recovery may take a little longer than after a first facelift.
Planning a revision
Bring details of your previous surgery, including the date, the type of lift and any operation notes if available. Mr Nassab will examine the scars, skin quality and deeper tissues, assess nerve function and discuss your concerns in detail. If you had surgery elsewhere, it is worth raising problems with your original surgeon first, as many have a revision policy. Revision deep plane surgery is quoted at consultation because it varies considerably; the consultation costs £150.
Recovery after revision
Expect a similar or slightly longer recovery than a first lift: swelling and bruising for two to three weeks, firmness for several months and final results assessed at around 12 months. Stop smoking, keep blood pressure controlled and follow the aftercare plan closely. Contact the surgical team urgently if one side of the face or neck swells rapidly.
Frequently Asked Questions
How soon after a facelift can revision be done?
Usually no sooner than 12 months, once swelling has settled and the scars have matured, unless an urgent complication needs treatment.
Can a pulled or windswept look be corrected?
Often it can be improved by repositioning the deeper tissues and releasing skin tension, although results depend on skin quality and scarring.
Is a revision facelift more expensive?
Revision surgery is quoted at consultation, as it is often longer and more complex than a first facelift.
Can a pixie ear be fixed?
An earlobe pulled down by a previous facelift can usually be repositioned, either during a revision lift or as a smaller procedure.
Is it possible to have revision after surgery abroad?
Yes, though limited records can make planning harder. Bring as much information about the original operation as you can.
