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Revision – Secondary Lift

If you have previously had a facelift or other facial rejuvenation, you may wish to freshen it after a number of years or you may desire revision because of a disappointing result. Either way Today’s Facelift can provide an excellent solution. This advanced procedure avoids the problems, such as being over pulled, and unnatural, of older techniques and can safely and more simply rejuvenate the “faded facelift.”

In most practices, re-do facelifts constitute only a small percentage of the facelifts each surgeon does. However, after moving to Highlands, NC, they make up over 60% of the facelifts Dr. Buchanan does. These secondary procedures are much more difficult than a primary facelift. This is because scar is much harder to deal with than unoperated tissue, the original anatomic positions have been altered, and there are frequently problems created by how the original procedure was done, how it healed or how you subsequently aged.

Though he was not a stranger to secondary facelifts, once in Highlands, and doing many more repeat facial rejuvenations, Dr. Buchanan was impressed with the need for a better solution than the standard facelift and the scarcity of literature on the subject. He, therefore, began to explore the problems and develop solutions. The first obvious solution was to stop separating the facial tissues into two layers. This process is hard the first time and impossible the second. He adopted the method of an internationally known Atlanta surgeon from the 1970’s, Dr. John Ransom Lewis. Dr. Lewis used sutures to reef the underlying support layer without trying to separate it and move it. Dr. Lewis’ results were spectacular and long lasting. This also allowed Dr. Buchanan to adjust the correction to each person’s individual needs. He then discovered the work of Drs. Patrick Tonnard and Alexis Verpaele from Gent, Belgium. Their procedure, the MACS Lift, incorporated the tissue reefing but used a shorter incision. Dr. Buchanan learned this technique from them and has adapted it, what he learned from his previous quest and subsequent study of the QuickLift and other modern techniques to fit your needs.

Today’s Facelift & Lower Blepharoplasty, late 50’s, wishing to
look happier and refreshed years after a previous Face Lift.



The Swoosh:

Older facelifts take the SMAS (the underlying support structure of the face) loose from the only place possible, near the ear and below the lateral cheekbone. Although trying to “lift” the face, the only direction possible is up and back. With these techniques, the central face remains mostly unmoved. This is why some people developed the “Mid-face Lift,” a procedure totally unnecessary with Today’s Facelift and Dr. Buchanan’s advanced Lower Blepharoplasty. As time goes by, the unfixed central face descends more than the relatively scared lateral face. This creates a “Swoosh” like appearance, occasionally with bands from the mouth, upward and lateral. The more sun damaged, the worse this appears.

A secondary facelift by Dr. Buchanan using Today’s Facelift corrects this problem by lifting and securing the mid-face and cheek, correcting the pull to a natural upward direction. This repositions the entire face to its original position.

Upper Cheek Crescent:

When seen from the opposite side, the cheek should have a gentle “S” shaped, ogee curve. With aging, and, particularly after a conventional facelift, this curve begins to look like a “3.” This is caused by a crescent shaped fullness below and lateral to the eye with a hollow beneath. The fullness is part of the eye closure muscle and fat that slides down and medial over the cheek bone. This looks even more dramatic next to the hollow created by older blepharoplasties that use fat removal as the main corrective measure.

Today’s Facelift and Lower Blepharoplasty by Dr. Buchanan can correct this problem by lifting the cheek fat and tightening the orbicularis muscle. This restores the natural ogee curve to the cheek and helps hide some of the orbital hollow. For advanced fat loss, fat grafting may also be added.

Hollow, Rounded Eyes:



Earlobe Malposition:

Frequently standard facelifts, which do not anchor the tissues to something solid, pull on the earlobe and stretch it down and forward as gravity and the tightly stretched skin pull on the ear lobe. Today’s Facelift corrects this automatically. Since the tissues that are elevated are attached to solid bone, there is little chance that the earlobe will descend again.

Elevated Sideburn:

This is an unfortunate consequence of most facelifts. Unfortunately, there is nothing short of hair grafts that will correct this. Today’s Facelift is designed to not worsen this problem (and, in primary procedures, prevent it).

Imbalanced Forehead:

For many years, facial rejuvenation consisted of a cheek lift and upper and lower Blepharoplasty (eyelid lift). The brow was rarely touched due to the truly unnatural appearance of the result, the difficulty of the procedure, and lack of understanding of the aging process. Several things happened:

This caused:

Because of the marked upward pull of Today’s Facelift, there is also frequently a bunching of the temporal tissues. To prevent this and rebalance the face, Dr. Buchanan frequently adds a full brow lift or a temporal lift. The full brow lift is usually done endoscopically with small incisions in the hair that heal rapidly with no visible scar and no nerve disturbance. It also removes the unnatural muscle pull between the eyebrows and preserves the forehead muscle function. This adds essentially no time to the postoperative recovery. The temporal lift heals even faster, but does nothing in the central forehead.

Imbalanced Skin:

Most facial rejuvenation in the past has concentrated on removing the sags and folds. Someone with tight, but crinkled, spotted skin, still looked old. Some surgeons have tried to correct the skin problems by tightly stretching the skin. This does not work, but causes many of the over-pulled problems of older facelifts. In order to truly rejuvenate the face, the skin also has to be addressed. Dr. Buchanan has several modalities available to accomplish skin restoration. The main method he uses is the Obagi® Skin Care System. TThis system addresses all the problems of skin aging except the abnormal blood vessels that occur in some people. It:

By thickening the dermis and moisturizing the skin, it eliminates many wrinkles. If crinkles and wrinkles remain, Dr. Buchanan can use one of several different peels or the advanced Luxor® CO2 Laser. For the red areas, he has the Elipse® IPL, the newest advance in light technology.

Whether your problem is one of the above or all of them, by individualizing Today’s Facelift, Dr. Buchanan can improve your appearance and rejuvenate your face. Contact the office to set up an appointment.

We can provide information on lodging and local activities for accompanying family or friends.



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