Surgical Technique Proves Crucial for Secondary Facelift

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A recent article in Plastic and Reconstructive Surgery® concludes that secondary facelift requires extreme precision. Dr. Thomas McNemar, a Bay Area cosmetic surgery provider, says technique is a vital component of facelift surgery at his practice.

San Ramon, California (March 2013) – A recent study shows that results from facelift surgery can last for nearly a decade. Furthermore, secondary and tertiary procedures can be performed successfully with very few complications (about the same as primary facelift surgery) and a similar duration for results. But with each procedure, the complexity of the procedure increases. Thomas McNemar, M.D. (, who specializes in intricate facial procedures for his Bay Area cosmetic surgery patients, comments.

As with any form of plastic surgery, facelift surgery, known medically as “rhytidectomy,” is a complex procedure. It requires great foresight, medical knowledge, creative skill and attention to detail. But secondary facelift can involve even greater complexity. An article in the March issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS), demonstrates the technical and experiential demands of follow-up facelift surgery.

“The challenge with secondary facelift procedures is working with the results of a previous surgery,” says Dr. McNemar. “Depending on the techniques used by the previous surgeon, your approach will vary.” The complexity of a secondary rhytidectomy is influenced by both the inherent sophistication of facelift surgery and the changes to the facial anatomy from an earlier procedure.

The surgeon must consider factors such as the extent of superficial and underlying scar tissue. Sometimes there is volume loss or a gaunt appearance caused by a facelift that included face or neck liposuction. At his Bay Area practice, Dr. McNemar may restore lost volume through collagen injections or fat grafting.

The authors of the study cite 5 R’s for success with secondary plastic surgery: resect, release, reshape, refill and redrape. But these may not apply to every patient.

The authors of the study noted that the 5 R’s are not hard-and-fast rules that apply to every patient. They are guidelines. The surgeon must assess every patient on an individual basis and determine a specific surgical plan for that individual. “Some plastic surgeons in the Bay Area take a one-size-fits-all approach,” says Dr. McNemar. “That approach is especially short-sighted with secondary procedures.”

Success with facelift surgery, or any surgical procedure, goes beyond the nuts and bolts of technique. Other responsibilities of the surgeon include building an open system of communication between patient and doctor (or practice), providing enough resources and information to ensure patients understand what is involved in the procedure, being sure that patients have reasonable expectations about the procedure and providing adequate after-care instructions and support.

Technique is crucial, but prospective patients should look for a surgeon that is willing to care for the whole person, says Dr. McNemar. Their philosophy and the culture of the practice should reflect this commitment to complete care.

Request a Consultation online today and receive a complimentary excerpt from Dr. McNemar’s new book Breast Augmentation & Body Contouring. Or, call (209) 834-0626 for our Tracy office to make an appointment.

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