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العربيةRevision Facelift
Revision facelift is surgery that corrects re-sagging after a previous facelift, or changes in scars, earlobes, or hairline.
- When revision is considered
- After at least 6 months have passed since the first operation
- No smoking before surgery
- 3 to 4 weeks before surgery
- Anesthesia, surgery time, hospital stay
- Varies depending on what is being corrected
Table of contents for this page
- When is a revision facelift done?
- How is revision surgery different from the first surgery?
- When can revision surgery be done?
- What is checked at a revision consultation?
- How is revision surgery done?
- What side effects can a revision facelift have?
- Are there cases where I should not have revision surgery, or should postpone it?
- How long does recovery after revision surgery take?
- How do I get a revision facelift consultation?
- Frequently Asked Questions
- Doctor's Column
- References
Since you have already had surgery once, looking into it again may feel heavier. We will first show you the basic criteria.
A Word from the Doctor
"I see people agonize even more when deciding on revision surgery."
Revision surgery is more demanding than the first surgery. For that reason, we explain below, one by one, what can be corrected, what has limits, and the side effects.
When is a revision facelift done?
We consult with you when your face or neck has sagged again, or when scars, earlobes, or hairline have changed and bother you.
From the five below, find what bothers you most right now. Each is explained separately in the subheadings below.
- If the face or neck has sagged again
- If vertical bands have formed in the neck again
- If the scar has widened or become raised
- If the earlobe has been pulled downward and looks attached to the cheek (pixie ear)
- If the temple hairline or sideburns have shifted, or hair around the incision line has fallen out
Having one of these does not mean we immediately recommend surgery. The first of our treatment principles is "We never recommend unreasonable surgery." If revision surgery leaves little room for improvement, we will tell you so.
When the face or neck has sagged again
Aging continues after surgery, so sagging can return over time.
Depending on the degree and location of the renewed sagging, we decide whether to redo a facelift, mini facelift, or neck lift.
When vertical bands have formed in the neck again
Vertical bands in the neck (platysmal bands) can become visible again even after a neck lift or double chin muscle tightening.
When the edges of the platysma (the thin muscle covering the front of the neck) separate again or thicken, vertical bands stand out in the neck. In some cases, fat left under the chin or salivary glands that have sagged look bulging.
Whether to treat the recurred vertical bands with a neck lift or with double chin muscle tightening is decided at your consultation based on the amount of remaining skin. Each surgery is explained in Neck Lift surgery information and Double Chin Muscle Tightening surgery information.
When the scar has widened or become raised
A scar where the incision line has separated and widened, or has become thick and raised, can be refined again.
If the scar is noticeable and bothers you, we will first tell you plainly what you can expect.
If the skin is sutured (stitched) while strongly pulled, tension continues to act on the incision line. This can lead to a widened scar or a hypertrophic scar (a thick, raised scar). Constitution also plays a part.
Whether to cut out the scar and suture it again, or to start with scar treatment such as injections or lasers, is decided by looking at the condition of the scar.
Revision surgery does not make the scar disappear. The goal is to adjust the width and position of the scar.
When the earlobe has been pulled downward (pixie ear)
A shape in which the earlobe is pulled down and forward and appears attached to the cheek is called pixie ear, and it can be corrected with revision surgery.
The name may be unfamiliar, but if you have noticed in the mirror that the shape of your earlobe has changed, please read this.
When the force pulling the skin falls directly on the earlobe while the incision line beneath the earlobe is being sutured, the earlobe is dragged down and forward as it heals. As a result, the natural boundary between the earlobe and the cheek disappears and the earlobe looks attached to the cheek. This is called a pixie ear deformity. It is a deformity that can occur after a facelift, and a literature review summarized it as seen in about 5% of cases in which a procedure to attach the earlobe was performed[8].
In simple terms — If the force of the skin pulled during surgery hangs on the earlobe, the earlobe is dragged down while healing and ends up attached to the cheek.
To correct it, the earlobe is detached and reattached in its proper place, so that the pulling force falls not on the earlobe but on the deeper layer beneath it.
When the hairline or sideburns have shifted
If the temple hairline and sideburns have shifted up and back, revision surgery can adjust them partly, but there are limits.
You may have been bothered by the changed line when tying up or sweeping back your hair.
If the incision line at the temple is placed inside the hair and the skin is pulled up and back, the hair-bearing skin is moved with it, so the temple hairline and sideburns can rise up and back. At the incision line that runs from behind the ear into the hair at the back of the head, the hairline can look misaligned like a step. If the hair follicles (the roots of hair) around the incision line are damaged, hair loss can occur there. There is a review that cites loss of temple hair and misalignment of the back hairline as typical traces left by the incision position, and summarizes incision designs that avoid them[9].
In simple terms — If the skin is pulled up from inside the hair, the area where hair grows also moves up, so the sideburns can become shorter or the temple hairline can recede.
A hairline that has already shifted can be restored to its original position only to a limited extent. The extent to which the incision line position can be changed or the problem supplemented in another way will be explained at your consultation.
How is revision surgery different from the first surgery?
In an area that has been operated on once, the tissue is stuck together, so revision surgery is more demanding than the first surgery.
If you know how it differs from the first surgery, the explanation you hear at your consultation will be much easier to understand.
Scar tissue forms where the first surgery was performed, and the layers adhere to each other (adhesion: tissue sticking together). As a result, the boundaries of the layers to be undermined (separated between layers of tissue) are less clear than in the first surgery. Within scar tissue, it is harder to predict where the branches of the facial nerve (the nerve that moves the muscles of facial expression) are.
Skin that has been lifted once may have reduced blood flow, so when it is lifted again the risk of skin necrosis (death of part of the skin) must be taken into account. Skin that has already been cut away cannot be restored, so there may be little room left to pull again. There is a review that summarizes revision surgery as complex because the skin, the SMAS and platysma, and the landmarks of the facial nerve have changed after the first surgery[10].
In simple terms — In an area that has been operated on once, the tissues are stuck together and the layers are hard to separate. It is hard to guess where the nerves are, and the blood supply to the skin may be less than at first. For that reason, revision surgery has more things to be careful about than the first surgery.
What can be restored and what has limits
Revision surgery cannot restore everything to the way it was.
To reduce the gap between expectation and reality, we have listed them candidly in advance.
| What is hard to restore or has limits | What can be adjusted |
|---|---|
| Skin that has already been cut away in large amounts | Position of tissue that has sagged again |
| Permanently injured nerves | Width and position of the scar |
| Fat that has been removed in large amounts | Position and shape of the earlobe |
| Complete restoration of a hairline that has shifted | Part of the left-right difference |
| Supplementing volume in sunken areas |
When can revision surgery be done?
Revision surgery is considered at least 6 months after the first surgery.
We fully understand the wish to fix things as soon as possible when you are bothered by the result. Even so, we first watch how it heals.
For several months after surgery, swelling remains and the scar tissue becomes firm before gradually softening. Until then, how you look now is not the final result. If surgery is done again while swelling and adhesions remain, the result is hard to predict.
Problems that need treatment right away, such as hematoma (a clump of collected blood), infection, or skin color changes, do not wait for 6 months. For these symptoms, please follow the guidance in Do not wait in these cases.
What is checked at a revision consultation?
We check when and what surgery you had, what the condition of the tissue is now, and what you most want to correct.
Revision surgery is considered only after at least 6 months have passed since the first surgery, so we first check whether this period has passed.
- Timing and method of the first surgery: when, what surgery, and how many times
- Current tissue condition: degree of adhesion, amount of remaining skin, how the scar has settled
- Priorities among the areas you want to correct: not everything can be solved at once
- Distinguishing what can be restored from what has limits
A Word from the Doctor
"This is true of a first surgery, of course, but in revision surgery these points can be even more meaningful. Understanding each other's exact requirements through sufficient consultation helps greatly in raising the chances."
If possible, bringing your previous surgery records or photos will help the consultation. Even without records, we can hold the consultation based on an examination.
If you have previously had a thread lift, please tell us when and how many times. Please also tell us about any medications you take, any illnesses you have, and whether you smoke. It need not be exact; tell us as much as you remember.
How is revision surgery done?
The method of revision surgery depends on what is being corrected, and ranges from surgery that pulls the sagging area up again to surgery that refines only a scar or the earlobe.
The method differs for each part to be corrected, so we have organized them in a table.
| Area to correct | Method | Anesthesia |
|---|---|---|
| Face has sagged again | A facelift or mini facelift is performed again | Anesthesia is similar to that for the same operation as the first surgery |
| Neck has sagged again, vertical bands have recurred | A neck lift or double chin muscle tightening is performed again | Anesthesia is similar to that for the same operation as the first surgery |
| Scar | The scar is cut out and sutured again | Local anesthesia |
| Earlobe deformity (pixie ear) | The earlobe is detached and reattached in its proper place | Local anesthesia |
| Hairline change | Decided at your consultation | Decided at your consultation |
For reference, at our clinic the first-time lift surgeries are as follows: a facelift is mainly under general anesthesia and takes 4 to 5 hours; a mini facelift is under local or sedation anesthesia and takes 1 hour 30 minutes; a neck lift is under sedation or general anesthesia and takes 2 to 3 hours. Revision surgery may take longer than the first surgery because adhesions have to be released.
The process of each surgery is explained in Facelift surgery information, Mini Facelift surgery information, and Neck Lift surgery information.
What side effects can a revision facelift have?
As with the first surgery, hematoma, facial nerve injury, and skin necrosis can occur, and in revision surgery more care is needed because of adhesions.
In addition, scars, reduced sensation around the ear, hair loss, changes in earlobe shape, asymmetry, and infection can occur. After a long operation under general anesthesia, a blood clot formed in a leg vein can, rarely, block a blood vessel in the lung.
This is information you need to know before deciding on surgery, so we have written it out in full without shortening it.
- Hematoma: Most occur early after surgery. A rapidly enlarging hematoma can block blood flow to the skin. If it forms deep in the neck, it can compress the airway. You may need a procedure to reopen the area and drain the blood.
- Facial nerve injury: Within scar tissue, the position of the nerve branches may have changed. If injured, facial expression can differ between left and right, for example the eye may not close fully or one corner of the mouth may droop.
- Skin necrosis: When skin that has been lifted once is lifted again, blood flow to the skin can become insufficient. Smoking raises this risk.
- Reduced sensation: Sensation around the ear and on the cheek can become dull. If the great auricular nerve (the nerve responsible for sensation of the earlobe and around the ear) is injured, sensation in the earlobe can become dull.
- Scar: A scar remains along the incision line. A hypertrophic scar can form where a scar has been reopened.
- Hair loss: It may occur around the scalp incision lines.
- Change in earlobe shape: After the area around the earlobe is sutured again, the earlobe can be pulled again.
- Asymmetry: the shape or recovery speed on the two sides may differ.
- Infection: The incision site can become red and swollen, with fever and pus. Antibiotic treatment may be needed.
- Deep vein thrombosis and pulmonary embolism (a blood clot formed in a leg vein blocking a blood vessel in the lung): Rare, but can occur after a long operation under general anesthesia.
In simple terms — The four problems below need treatment right away.
- Pooled blood
- Injury to the nerve that moves facial expressions
- Death of part of the skin
- A blood clot in a leg vein blocking the blood vessels of the lungs
In revision surgery the tissue is already stuck together, so these problems require more care than in the first surgery. Scars, reduced sensation, hair loss, and changes in earlobe shape are changes that occur at and around the incision.
How Often Did Side Effects Occur in the Literature?
How we respond at our clinic when each side effect occurs (draining a hematoma, monitoring the course of a nerve injury, etc.):
If you suspect any of the symptoms above, please follow the guidance in Do not wait in these cases.
Are there cases where I should not have revision surgery, or should postpone it?
Yes. Typical cases are when 6 months have not passed since the first surgery, when stopping smoking is difficult, and when blood pressure is not controlled. Criteria based on your health condition are confirmed at your consultation.
Surgery is not right for everyone right now.
Facelift surgery requires stopping smoking for 3 to 4 weeks before surgery. This period follows the criteria of a meta-analysis that examined the length of smoking cessation before surgery. Revision surgery works again on skin that has been lifted once, so stopping smoking may be even more important.
- If 6 months have not passed since the first surgery: Swelling and adhesions remain, so the result is hard to predict.
- Smoking: It reduces blood flow to the skin and raises the risk of skin necrosis and delayed wound healing. Based on the literature, our clinic asks you to stop smoking for 3 to 4 weeks before surgery.
- Uncontrolled high blood pressure: The risk of hematoma increases.
- If you have a bleeding tendency or are taking an anticoagulant (a blood-thinning medication): Coordination is needed with the doctor who prescribed the medication.
- If you have an underlying condition that is not under control
In plain terms
- Cigarettes reduce blood supply to the skin and interfere with wound healing.
- In revision surgery, there may be less blood going to the skin than at first, so the effect of cigarettes may be greater.
- If your blood pressure is high or you take blood-thinning medicine, the risk of blood pooling after surgery increases.
- Please do not stop your medicines on your own; tell us at your consultation.
To male patients: In several studies, male sex has been reported as a risk factor for hematoma after a facelift[11][19][20].
How long does recovery after revision surgery take?
Generally, you can resume daily life to some extent 1 to 2 weeks after surgery. The recovery time until most of the swelling goes down varies depending on which surgery is redone, and may be similar to or longer than the recovery time for the same surgery the first time.
If you have work or an important appointment coming up, this is probably what you most want to know. If you have an important schedule, please tell us in advance at your consultation.
Surgery that refines only a scar or the earlobe and surgery that pulls the sagging area up again have different recovery schedules.
So that you do not have to endure recovery alone, the doctor and the nursing team check your swelling, pain, and condition together. The third of our treatment principles is “We see patients more frequently after surgery.”
Precautions after surgery
Do not apply cold or hot compresses. After surgery, skin sensation is reduced, so applying something cold or hot can cause burns.
For about a month after surgery, please be careful about lifting heavy things or straining. Bleeding can occur.
Sleeping position, when to start washing your face, shampooing, makeup, and hair dye, when to resume exercise, drinking, and saunas, and how long to stay smoke-free after surgery:
Do not wait in these cases
The changes below are ones you should report to us without waiting until your next visit. If you have difficulty breathing, call 119 right away.
If something feels wrong after surgery, do not put up with it on your own.
Symptoms that call for an immediate call to 119 or a trip to the emergency room
- When your neck swells and it becomes hard to breathe or swallow
- When you are short of breath or have chest pain
Symptoms to have checked promptly
- When one side of the face or neck suddenly swells, becomes tight, and the pain becomes severe
- When your expression becomes different on the left and right, such as an eye that does not close fully or a mouth corner that droops on one side only
- When the skin around the incision turns dark or deep purple
- When the incision site becomes red and swollen, you have a fever, or pus drains
- When one calf becomes swollen and painful
Changes you must tell us about at your next visit
- When dulled sensation around the ear stays the same even after several months, or a tingling pain develops
- When the scar becomes more raised or itchy
- When the spots where hair was lost stay the same even after several months
- When the earlobe is pulled downward again or looks attached to the cheek
- When the left-right difference does not lessen over time
If you suddenly develop swelling or shortness of breath outside clinic hours, go to the nearest emergency room or call 119.
How do I get a revision facelift consultation?
You can call our main number, 02-541-8500, or apply through Consultation & Booking information.
If you still have questions after reading this, please feel free to ask them at your consultation.
Revision surgery is considered at least 6 months after the first surgery.
The clinic is located on the 4th floor of Vorati Al Building, 480 Gangnam-daero, Gangnam-gu, Seoul. It is a 1-minute walk from Exit 3 of Sinnonhyeon Station.
At your consultation, please tell us when and where you had your previous surgery, any medications you take, and whether you smoke. If possible, bringing your previous surgery records or photos will help the consultation.
Frequently Asked Questions
If I am not satisfied with the result after a facelift, when can I have surgery again?
Revision surgery is considered only after at least 6 months have passed since the first surgery. Before then, swelling and adhesions remain, so how you look now is not the final result. However, we do not wait on problems that need treatment right away, such as hematoma, infection, or skin color changes.
Is revision surgery riskier than the first surgery?
It is more demanding. In an area that has been operated on once, the tissue is stuck together, so more care is needed with the nerves and blood flow to the skin than the first time. Side effects such as hematoma, facial nerve injury, and skin necrosis can occur just as with the first surgery.
Can an earlobe pulled downward (pixie ear) be corrected too?
It can be corrected by detaching the earlobe and reattaching it in its proper place. The goal is to keep the pulling force from acting on the earlobe again.
When can I return to daily life after revision surgery?
Generally, you can resume daily life to some extent 1 to 2 weeks after surgery. It takes longer than this for most of the swelling to go down, and it varies depending on which surgery is redone.
When should I stop smoking before revision surgery?
You need to stop smoking for 3 to 4 weeks before surgery. In a meta-analysis pooling several studies, wound-healing complications decreased when people stopped smoking for 3 to 4 weeks or more. Revision surgery works again on skin that has been lifted once, so stopping smoking may be even more important.
Is revision facelift covered by national health insurance too?
Facelift surgery for cosmetic purposes and surgery to treat its after-effects are non-covered treatments that are not covered by national health insurance.
Doctor's Column
A facelift is not a single surgery; it is divided into several approaches.
Published 2025-08-06 · Updated 2026-10-01Read Common Questions & Stories from PracticeIs Plastic Surgery Just a Matter of Luck?Plastic surgery results are closer to probability than to luck, and the probability can be raised.
Published 2020-09-15 · Updated 2026-09-23ReadReferences
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He personally consults on and performs facial aging treatments such as facelift, droopy eyelid surgery, and thread lift. The doctor personally sees you from consultation through recovery.
About the DoctorThe content of this page is general medical information provided in accordance with the Medical Service Act, and the effects and recovery time of surgeries and procedures may vary by individual. All surgeries and procedures can cause side effects, so please make your decision only after a thorough consultation with a plastic surgery specialist.