Longevity of SMAS facial rejuvenation and support.

[BACKGROUND] One of the most common questions asked by patients when they present for face lift surgery is "How long will this last?" The answer to this question is not clear from the literature.

[METHODS] The purpose of the study was to review a series of secondary face lifts performed between 2001 and 2008 with both the primary and secondary face lift performed by a single surgeon. There were 42 patients with full records available for review. Data were collected with regard to timing, surgical technique, complications, and reasons for early revision.

[RESULTS] The average age at the primary face lift was 50.2 years (range, 34.9 to 69.9 years) and the average age at the secondary face lift was 61.9 years (range, 43.6 to 77.2 years). The average length of time from the primary to secondary face lift was 11.9 years. Nine patients required a secondary face lift before it had been 5 years since the primary face lift (21.4 percent). Reasons for early secondary face lift (within 5 years of the primary) included loss of skin elasticity in five patients and increase in subplatysmal fat and skin neck folds due to weight gain, loss of elasticity secondary to protease inhibitors for human immunodeficiency virus infection, loss of skin elasticity due to corticosteroid use, and residual fullness of digastric and residual submental fat in one patient each.

[CONCLUSIONS] On average, a well-performed superficial musculoaponeurotic system flap face lift will last 12 years. Those patients who present with very poor skin elasticity secondary to sun damage may require an earlier secondary face lift.