Secondary facelift achieves good results, reports plastic and reconstructive surgery

(Press-News.org) Philadelphia, Pa. (February 28, 2013) – Performed an average of a decade after initial facelift surgery, a "secondary" facelift can achieve similarly lasting results with a low complication rate, according to a paper in the March issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

Dr. Rod J. Rohrich and colleagues of University of Southwestern Medical Center, Dallas, report their 20-year experience with secondary facelift surgery, or "rhytidectomy." The researchers conclude that, with attention to some key surgical principles, "Secondary rhytidectomy is a safe and effective procedure for continued surgical facial rejuvenation in the aging patient."

Experience Shows Good Results with Secondary Facelift Surgery
From 1990 through 2010, Dr. Rohrich performed more than 800 facelift operations. Sixty of those were secondary facelifts—repeat procedures to treat recurrent signs of facial aging. The new study reviewed this experience to gain insights into the technique, outcomes and longevity of the results of secondary facelifts. (The analysis excluded patients undergoing minor "revisions" after facelift surgery.)

The experience included 57 women and three men undergoing secondary rhytidectomy. The patients averaged 51 years of age at the time of their initial facelift and 60 years at their secondary facelift. Thus for these patients, the results of the initial facelift lasted an average of nine years.

Of the 60 patients undergoing a second facelift, 10 later underwent a third facelift procedure. The time between the second and third procedures was 7.5 years—suggesting that the results of the secondary facelift lasted about as long as those of the initial procedure.

The complication rate after secondary rhytidectomy was about five percent. Consistent with previous studies, the risk of complications was about the same after secondary versus primary facelift surgery. In contrast to some reports, there was no increase in the rate of facial nerve injury after secondary facelift.

Study Highlights Importance of the 'Five R's'
An increasing number of patients have undergone second or even third facelifts in recent years. "With an ever-growing middle-aged population and an overall interest in facial rejuvenation at an earlier age, there has been a substantial increase in patients undergoing secondary rhytidectomy," according to Dr. Rohrich and colleagues.

While their experience suggests good results, researchers emphasize that secondary facelift procedures may require some unique surgical techniques. Dr. Rohrich and colleagues outline some important principles for plastic surgeons to follow in planning and carrying out secondary facelifts. They write, "Adherence to the five R's of secondary rhytidectomy (resect, release, reshape, refill and redrape) will enable the plastic surgeon to safely restore youth and correct stigmata of primary facelift."

The article includes brief descriptions of individual cases illustrating the authors' approach to some of the unique challenges of secondary rhytidectomy—reflecting not only the effects of continued aging, but also some "stigmata" of the initial facelift. Dr. Rohrich and colleagues conclude, "Use of five 'R's' described in this article…will help patients return to a natural and youthful look of beauty, even a second time."

### Plastic and Reconstructive Surgery® is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.

About Plastic and Reconstructive Surgery
For more than 60 years, Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons, Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, and cosmetic surgery, as well as news on medico-legal issues.

About ASPS
The American Society of Plastic Surgeons (ASPS) is the world's largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery. You can learn more and visit the American Society of Plastic Surgeons at www.plasticsurgery.org or www.facebook.com/PlasticSurgeryASPS and www.twitter.com/ASPS_news.

About Lippincott Williams & Wilkins
Lippincott Williams & Wilkins (LWW) is a leading international publisher of trusted content delivered in innovative ways to practitioners, professionals and students to learn new skills, stay current on their practice, and make important decisions to improve patient care and clinical outcomes.

LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2012 annual revenues of €3.6 billion ($4.6 billion).