When patients write to me about a facelift they are unhappy with, the problem is usually one of a few: a face that looks pulled rather than younger, an earlobe that has changed shape, a visible scar, or jowls that came back within a year. Their questions are almost always the same three: will it settle on its own, can it be corrected, and when?
This page answers them. I will not comment on any other surgeon, clinic or country: I was not in that operating room, and several of these problems can also follow a carefully performed operation. For a first facelift, see my deep plane facelift page, and for how the two main techniques differ, deep plane vs SMAS facelift.
What a “Facelift Gone Wrong” Is, and What It Is Not
A facelift that went wrong is a result that, once healing is complete, looks unnatural, shows the surgery, or did not last as long as it should have. Patients search for the same problems under many names:
- Facelift revision, revision facelift, secondary facelift. A second operation on a lifted face, to correct the first or, years later, because the face kept aging.
- Bad, botched or failed facelift. I avoid “botched”, because it assigns blame where I have no information.
- Pulled, windswept or “wind tunnel” look. A face pulled sideways, with flat, tight cheeks. Surgeons call this a lateral sweep.
- Pixie ear. An earlobe pulled down and forward that now looks attached to the cheek.
- Visible facelift scars. Scars around the ear that are wide, raised or discolored, or that cross visible skin.
- Hairline shift. A sideburn that has moved up or disappeared, or a step in the hairline behind the ear.
- Early relapse. Jowls and a loose neck that returned within a year or two.
- Facial nerve weakness. A smile, lower lip or brow that does not move as it did before.
Three things are not a facelift gone wrong. Swelling and tightness in the first three months, described in the facelift swelling timeline. A face that has aged again ten years after a good lift, which calls for a second facelift; see how many facelifts you can have. And problems caused by fat or filler rather than by the lift, covered in fat transfer to the face gone wrong.
What Typically Goes Wrong After a Facelift
In one surgeon’s review of 72 revision facelifts among 552 facelifts, about two in three revision patients had a distorted hairline or poorly placed incisions, one in seven had a pixie ear, one in seven had an undercorrected neck or mid-face, and one in five had no deformity at all, only a face that had aged again (Skouras 2020). Many of these problems share one mechanism: tension carried by the skin instead of by the deeper layer.
The pulled or windswept look
When the skin is pulled toward the ear to do the work of the deeper layer, the face looks stretched sideways: tight, but not younger. Early on, part of this is swelling, which softens; a pull still clearly visible at six months is built into the tissues.
Jowls that came back too soon
Jowls and a loose neck within a year or two usually mean the skin was tightened without moving the deeper layer, or the operation did not reach the area that needed it. Skin was never meant to hold up the weight of the face, so a skin-only lift relaxes early. Weight loss after surgery, including on GLP-1 weight-loss medication, can produce the same picture without any surgical failure.
Scars that show
A facelift always leaves scars; what matters is where they sit and how they heal. Scars widen and thicken mainly when the skin is closed under tension. In a pooled analysis of 10,784 patients who had deep plane facelifts, raised (hypertrophic) scarring occurred in 2.8 percent (Koroma 2026).
The pixie ear
The lifted cheek skin pulls the earlobe down and forward, so the lobe loses its free lower edge and looks stuck to the face. A literature review puts it at about 5 percent of facelifts in which the earlobe is reattached, and calls it one of the telltale signs of a facelift (Vaccari 2024). It is caused by tension on the earlobe, and once healed in that position it tends to stay.
A hairline that moved
The sideburn and temple hairline can move up with the lifted temple skin, and behind the ear the hairline can end up with a visible step. In the revision series above, a receding temple hairline was the hardest problem to correct; in 10 of the 72 patients it could not be corrected (Skouras 2020). For a sideburn that has disappeared, moving skin back down has limits, and a hair transplant into the temple is often the honest answer, done once the revision has healed.
Weakness of a facial nerve branch
A 2025 systematic review found weakness of a facial nerve branch in 0.5 to 5 percent of facelifts. Most cases were neuropraxia, a nerve stretched or bruised rather than cut: about 70 percent of patients recovered fully within six months, and about 10 percent had a lasting deficit (Arianpour 2025). In the pooled deep plane data, temporary weakness occurred in 1.2 percent and no permanent injury was reported (Koroma 2026).
Skin loss
Lifted skin depends on a reduced blood supply for the first weeks. If too little reaches the edge, usually behind the ear, a patch darkens and is lost. This is rare, 0.1 percent in the pooled deep plane data (Koroma 2026), and smoking is the most clearly documented cause: a classic study attributed a significant number of skin losses after facelifts to cigarette smoking (Rees 1984). The area heals over weeks with wound care, and the scar can be improved later.
What Settles on Its Own, and What Does Not
These usually improve with time:
- Swelling, tightness and uneven swelling. Normal for weeks and often months. A face can look tighter at six weeks than it will at six months.
- Numbness of the cheeks and ears. It fades over months.
- Red, firm scars. Color and firmness fade over the first year.
- Most nerve weakness, usually within months.
These usually do not improve by themselves:
- A pixie ear that is still present once the swelling has gone.
- A sideburn or temple hairline that has moved or disappeared.
- A wide scar. Its color fades, but its width does not shrink.
- Jowls, neck laxity or a sideways pull that are still there after six months.
- Lost skin, which heals as a scar.
Some problems cannot wait. In the first days and weeks, sudden swelling on one side, rapidly worsening pain, fever, spreading redness, discharge or a darkening patch of skin must be seen in person, quickly, by the surgeon who operated or by a local doctor. Bleeding under the skin (a hematoma), the most common major complication at 1.1 percent of 11,300 facelifts (Gupta 2016), is treated within hours, not months. Photographs are no substitute for that examination. If you were operated on elsewhere and can reach Istanbul, I see and treat these early problems too; the condition is that you come, because this is not a question I can settle by photograph.
When a Revision Helps, and When It Does Not
A revision helps when the problem is structural and the tissues have settled: a pull in the wrong direction, an earlobe under tension, scars that are wide because the closure was tight, jowls that were never corrected, or volume that was lost and not replaced. The correction works on the cause rather than the symptom: tension moved from the skin back into the deep layer, scars revised once the pull behind them is gone, and lost volume restored.
A revision does not help, or not yet, when:
- The face is still healing.
- A nerve is still recovering. Another operation does not make a bruised nerve recover faster.
- The concern is skin quality. Fine lines and texture need skin treatments such as laser and mesotherapy, not another lift.
- You smoke or use nicotine. Skin that has been lifted before depends even more on its blood supply; read my page on smoking and surgery first.
- Your weight is still changing. As before a first facelift, I want it stable for three to six months.
Non-surgical treatments have a limited place. Laser and mesotherapy improve the skin but cannot move an earlobe or a hairline; filler cannot undo a pull, and in a stretched face it adds weight rather than youth. Threads give a short-lived pull, and I do not perform thread lifts; in the revision series, earlier thread lifts had tethered the layers of the face together in 10 of the 72 patients (Skouras 2020).
How I Plan a Facelift Revision
Some of the facelift patients I see have had a lift elsewhere and want it corrected. A revision is more demanding than a first lift, because the planes are scarred and the anatomy has already been moved. The plan therefore starts with what the first operation did, and the operation report and photographs from before the first facelift help.
Unless there is a problem that cannot wait, I ask for six to twelve months after the previous operation, so that swelling has settled and the scars have matured. In a revision I follow the same principle as in every facelift I perform: the deeper layer carries the lift, and the skin is closed without tension. The individual steps depend on what was done before and on what I find, and we go through them together in the consultation.
Faces that need a revision have often lost volume as well as position, so fat grafting is part of many plans, and eyelid surgery, a brow lift or a neck lift join the same session when the face needs them, exactly as in a first facelift. Fat goes only into the regions we agreed on; I explain why in fat transfer is a graft, not a filler. A facelift, first or revision, is never combined with body surgery.
Your Week in Istanbul
- Day 0: surgery under general anesthesia in an accredited hospital, with an anesthesiologist present, and one night in hospital. The stay and the Istanbul plan are the same as for a first facelift.
- Days 1 to 3: rest at your hotel with a compression garment, thin adhesive strips along the incisions, and a hemostatic net if one was placed. My team is in touch with you every day.
- Day 3: the net comes off, drains come out if any were used, and I check your face.
- Days 5 to 7: final examination the day before you leave, then you fly home.
Recovery After a Facelift Revision
Plan for the same milestones as a first facelift. Most patients are presentable in ordinary company and back to desk work at around two weeks, and exercise restarts between weeks four and six. No lymphatic massage is needed after a facelift. The warning signs listed above mean contacting my team straight away.
I judge the final result of a revision at twelve months. The recovery planner turns your surgery date into a day by day calendar.
Risks and Honest Limits
A revision carries the same kinds of risks as a first facelift: bleeding under the skin, infection, nerve weakness, numbness, skin loss and scars. In the database of 11,300 facelifts, 1.8 percent had a major complication, most often a hematoma (1.1 percent) or an infection (0.3 percent) (Gupta 2016). In a matched comparison of 97 secondary and 97 primary facelifts by one surgeon, complication rates did not differ (Mandelbaum 2026).
The limits matter just as much:
- A revision improves; it does not erase. The earlobe and the hairline keep some memory of what was done.
- A lost temple hairline may not be fully restorable by moving skin alone; where the sideburn is gone, a hair transplant into the temple is the better tool, planned after the revision has healed.
- A revised scar is still a scar. It can be narrower, flatter and better placed; it does not disappear. How scars mature and what helps them is on my scar revision page.
- A permanent nerve injury is not reversed by a cosmetic revision.
- Every operation uses some tissue. Layers that have been lifted before are thinner, which limits what each further operation can do.
- Sometimes the right advice is to do nothing more. If I do not think a revision will make your face better than it is now, I will say so.
What Shapes the Price and What Is Included
I do not publish a single price, because a revision is planned around what the first operation left behind. The quotation depends on:
- What needs correcting: the deep layer, the neck, the scars, the earlobes, the hairline, lost volume, or several of these.
- What is combined: eyelid surgery, a brow lift or fat grafting in the same session.
- Operating time: scarred planes slow every step.
- The hospital stay and the length of your stay in Istanbul.
I quote in writing after reviewing your photographs and, usually, after a video consultation. Every quotation is all inclusive: the surgery, the hospital stay, the anesthesia, medication, the compression garment (if relevant), your accommodation, airport and clinic transfers, and the follow-up visits and post-operative contact in Istanbul.
Before and After: How to Read the Photographs
In revision photographs, look at the ear, the earlobe, the sideburn and the hairline behind the ear with the hair pulled back, because that is where both the problem and the correction show. Compare the same angle under the same light, including profile and oblique views, and ask when the after photograph was taken: at three months swelling still smooths everything; the honest photograph is at twelve months.
Most of my facelift patients do not want their face published, even with the eyes covered. My results with consent are in the before and after gallery, and in a video consultation I can show you more cases with a starting point similar to yours.
Send your photographs for an assessment. Front, both sides and both oblique views with your hair pulled back so that the scars, earlobes and hairline are visible, plus a close-up of each ear. Add the date of your operation, the operation report if you have it, and a photograph from before the first facelift if you can find one. Send them on WhatsApp, +90 544 772 0772, or by email, info@mustafaaydinol.com, whichever you prefer.
Frequently Asked Questions
How long should I wait before a facelift revision?
Six to twelve months after the previous operation, unless there is a problem that cannot wait. By then the swelling has settled and the scars have matured, so we are both looking at the real result.
Can a pixie ear be corrected?
Usually it can be improved. The key is taking the tension off the earlobe. When the rest of the face is fine, I correct a pixie ear, like a wide or visible scar, as a small separate operation under local anesthesia, and you go home the same day; when the face has relapsed as well, it is corrected as part of the wider revision. The earlobe will look better, but not as if it had never been operated on.
Will my facial nerve weakness recover?
In most patients it does: in a systematic review, about 70 percent recovered fully within six months. A weakness that is still improving should be given time; one that has not changed after a year I refer to a specialist in facial nerve problems, which is a separate question from a cosmetic revision.
Is a revision facelift riskier than the first one?
Not in the published data: in a matched comparison of 97 secondary and 97 primary facelifts, complication rates did not differ. A revision is technically harder; what changes is how much the result can achieve.
Can you correct a facelift that was done in another country?
Yes. What was done matters much more than where, and I do not comment on the first surgeon. Send your photographs, the date of the operation and, if possible, the operation report, and I will tell you honestly whether a revision makes sense now, later or not at all.
About the Surgeon
Dr. Mustafa Aydınol is a plastic, reconstructive and aesthetic surgeon practicing in Istanbul, a member of ISAPS and of the Turkish Society of Plastic Reconstructive and Aesthetic Surgeons. The practice holds Health Tourism Authorization from the Turkish Ministry of Health.
Sources
- Skouras GA, Skouras AG, Skoura EA. Revision and secondary facelift: problems frequently encountered. 72 revision facelifts among 552 facelifts; hairline distortion or poorly designed incisions in 67 percent, pixie ear in 14 percent, undercorrection in 14 percent, no stigmata in 20 percent; receding temple hairline uncorrectable in 10 patients; tethering from earlier thread lifts in 10 patients. Plastic and Reconstructive Surgery Global Open, 2020. DOI
- Koroma P, Reji N, Burridge I, et al. Deep plane facelifts: a systematic review and meta-analysis of outcomes. 45 studies, 10,784 patients; overall complications 6.6 percent, temporary facial nerve injury 1.2 percent, no permanent nerve injury, hematoma 1.8 percent, hypertrophic scarring 2.8 percent, skin necrosis 0.1 percent. Aesthetic Plastic Surgery, 2026. DOI
- Arianpour N, Khiabani K, Aberoumand H, Pourhoseini A. Management and outcomes of facial nerve injury following rhytidectomy: a systematic review. 20 studies; incidence 0.5 to 5 percent, neuropraxia in 80 to 90 percent of cases, full recovery within six months in 70 percent, persistent deficit in 10 percent. Maxillofacial Plastic and Reconstructive Surgery, 2025. DOI
- Vaccari S, Fondrini R, Ragaini E, et al. The pixie ear: how to prevent and correct it, a review of the literature. Pixie ear identified in about 5 percent of earlobe inset cases; caused by the tension vectors of the facelift flap. Surgery, 2024. DOI
- Gupta V, Winocour J, Shi H, Shack RB, Grotting JC, Higdon KK. Preoperative risk factors and complication rates in facelift: analysis of 11,300 patients. Major complication rate 1.8 percent; hematoma 1.1 percent, infection 0.3 percent. Aesthetic Surgery Journal, 2016. DOI
- Mandelbaum M, Mordukhovich I, Vishwanath N, et al. Interval to secondary facelift: a match-cohort analysis of interval time, technique, and complications. 97 secondary and 97 matched primary facelifts; complication rates did not differ; mean interval 10.7 years. Aesthetic Surgery Journal, 2026. DOI
- Rees TD, Liverett DM, Guy CL. The effect of cigarette smoking on skin-flap survival in the face lift patient. A significant number of skin sloughs after facelift were attributed to cigarette smoking. Plastic and Reconstructive Surgery, 1984. DOI
