Revision Facelift
Surgery in Harley Street, London

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 30% of Dr De Silva’s patients are revisions surgeries.

How Do You Approach Revision Facelift Surgery?

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 surgery can be completed to improve the shape and expectations are important to discuss.

Because 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 revision facelift 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 face and neck lift surgery will remove some excess loose skin or further tightening of the neck. There are also further limitations during a revision surgery 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.

A revision facelift in London can be very challenging with a combination of scar tissue and a change in natural anatomy; realistic expectations are an important consideration.

What is Different in Revision 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.

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 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 avoid 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.

Will I Be Happy?

Dr De Silva only provides patients with sincere information on results from revision facelift 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.

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.