Overview
Secondary facelifts are increasing, but few studies analyze them in detail. The authors matched primary and secondary facelift patients treated by one surgeon between January 2014 and January 2024 by demographic and medical characteristics. They compared technique, added procedures, operating time and complications, and used the time between facelifts as a measure of how long a facelift lasts.
Findings
- 97 patients in each group.
- Secondary facelifts were 44.3 minutes shorter than primary facelifts (P < .01).
- Secondary facelifts were more likely to use SMAS plication (P < .01).
- Complication rates did not differ between groups.
- Major complications counted: unplanned admission, reoperation and persistent motor nerve injury. Minor complications were those managed as an outpatient.
- Mean interval between primary and secondary facelift: 10.7 ± 4.9 years.
- Younger age at the first facelift correlated with a longer interval to the second (r = -0.44, P < .01).
What it means for a patient
- A second facelift, in this surgeon's hands, carried the same complication rate as a first.
- Patients who returned for a second facelift did so about 10.7 years after the first, on average.
- People who had their first facelift younger waited longer before a second one.
- The authors support sub-SMAS dissection when tissue quality permits and SMAS plication when a more conservative approach is warranted.
- Limits: one surgeon, retrospective design, and the interval only counts patients who came back. It is a stand-in for how long results last, not a direct measure.
Why this paper matters
It gives matched data showing secondary facelifts can be done with complication rates comparable to primary ones. It supports choosing sub-SMAS dissection or SMAS plication in a secondary facelift based on tissue quality.
Terms
- Primary facelift: a person's first facelift.
- Secondary facelift: a repeat facelift after an earlier one.
- SMAS: the superficial musculoaponeurotic system, a fibrous and muscle layer under the facial fat.
- SMAS plication: folding and stitching the SMAS layer to tighten it without cutting under it.
- Sub-SMAS dissection: lifting the tissue by freeing it beneath the SMAS layer.
- Matched cohort: two groups paired on traits such as age and health so they can be compared fairly.
- Correlation coefficient (r): a number from -1 to 1 showing how closely two measures move together.