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  • Writer's pictureDr. Jean-Paul Azzi

What is a Revision Facelift?

A secondary facelift or revision facelift is a facelift performed after a patient has already had a facelift procedure. Dr. Jean-Paul Azzi is a double board-certified facial plastic and reconstructive surgeon who is an expert on revision facelift procedures. In fact, people travel from around the country to see him for secondary facelifts.

You may be thinking, “Why would someone want or need a second (or even third) facelift?”

There are several reasons, actually. A few common ones are:

Re-tightening is needed

Even when the primary facelift was well-executed, the natural aging process over time has will cause enough movement to the jowls and neck that the tissues need to be re-tightened or lifted. A well-performed deep-plane facelift can last over 10 years, while the most commonly performed type of facelift (>90%) - a skin lift - will only last 1 to 3 years. The most common problems people experience with these older types of very commonly performed facelifts is that the jowls, neck, and cheeks quickly droop again. Even worse, this tension on the skin incisions causes them to widen leaving visible scars.

Pixie Ear Deformities

Another common complication Dr. Azzi corrects during revision deep-plane facelift is pixie ear deformities. This is caused by a skin lift drooping prematurely and pulling the ear lobes down causing them to appear stretched.

Cobra Neck

Another common deformity Dr. Azzi treats during a revision facelift is "cobra neck”. This is caused by either an improperly performed neck lift or the use of liposuction under the neck combined with a superficial facelift or skin lift. This causes the center of the neck to look caved while the jowls quickly droop around them in the shape of a cobra snake. This happens because the deeper structures of the face were not addressed and fall to their previous positions. In most cases, a proper platysmaplasty, or necklift, can repair the deformity


In a small number of cases, a patient will present for consult because of wide scars from their superficial facelift prior. Remember, scarring is always from tension on the skin. This tension is caused by excessive skin tightness. Performing a scar revision for these cases will often produce the same results or worse. This is because a scar revision simply adds to the tension without addressing the heavy deeper structures in the face that are causing the aging. The only solution in these cases is the perform a revision deep-plane facelift and support the deeper structures, thereby taking the tension off the skin and providing a long-lasting, natural and youthful facelift.

Patients are unhappy overall with the primary facelift

Sometimes, Dr. Azzi will see patients who come to him unhappy with the work of another surgeon. This is especially common in the case of patients who have had older fashioned facelifts (not deep-plane facelifts) which tend to look "done" or "wind-swept".

Here are some examples of what can be achieved with a revision facelift by Dr. Jean-Paul Azzi:

Revision facelift before and after photos by Dr. Azzi

Revision facelift before and after photos by Dr. Azzi

Revision facelift before and after photos by Dr. Azzi

If you’re considering a revision facelift, we cannot stress enough the importance of seeking out a board-certified facial plastic surgeon who specializes in revisions, like Dr. Azzi. This is because revision facelifts are one of the most challenging procedures to perform in cosmetic surgery.

Here’s why…

There is always going to be a variable amount of scar tissue, a thinned SMAS and platysma layer and a variability of skin incisions used in the initial lift. For these reasons, and the fact that the patient tends to be older when they decide to get a secondary facelift, this procedure requires a high level of expertise.

Doctor Azzi explains the complexity of the secondary facelift and why it is important to find a doctor with the right level of education and experience to perform this type of procedure.

He says, “Patients who consult me for revision facelift surgeries are going to have much different needs than the typical facelift patient. I tailor each procedure for the specific needs of the facelift patient taking into account the issues and scar tissue from the previous aging face procedure."

The best thing to keep in mind when considering a secondary facelift is the fact that there isn’t a one-size-fits-all solution. The surgeon needs to be skilled enough to treat each patient as the individual they are and base the technique used on what they see in-front of them.

Dr. Azzi is an expert in making adjustments tailored specifically to each facelift patient to successfully correct the aging problem. He always uses his expertise as a specialized facial plastic surgeon to evaluate the entire face and determine if any other procedures could be beneficial to the treatment of the aging process. Procedures that are typically considered include browlifts, mid-facelifts, blepharoplasties or "eyelid lifts" and fat grafting for volume-related aging issues.

If you’re interested in a revision facelift, we welcome you to schedule a free consultation with Dr. Azzi to discuss your options. During your consultation, Dr. Azzi will discuss your cosmetic wishes with you and will make recommendations about the best approach to achieve your desired result.

With offices located in Jupiter and Palm City, Florida, Dr. Azzi is widely known as one of the top plastic surgeons in Florida.

Dr. Azzi and his staff serve patients in the following South Florida areas and beyond: Jupiter, Palm Beach Gardens, Palm Beach, West Palm Beach, Tequesta, Hobe Sound, Stuart, Palm City, Jensen Beach and Vero Beach. If you're not local, no problem, click here.

Please call (561) 429-5403 or contact us online by clicking here.

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