Beale · Plastic and reconstructive surgery 2013 · retrospective case series · n=60

A 20-year experience with secondary rhytidectomy: a review of technique, longevity, and outcomes.

Cited 44 times in the scientific literature.

Level 4 - case-series / case-control

Retrospective single-surgeon case series without an independent control group

PubMed 23142942 · doi:10.1097/PRS.0b013e31827c70f1 · record verified 2026-08-29

What was done

A retrospective chart review evaluated 811 total face lifts performed over a 20-year period by a single surgeon, focusing on 60 secondary rhytidectomies and 10 tertiary procedures. The study evaluated surgical technique based on the five Rs (resect skin/scar, release abnormal SMAS vectors, refill with fat grafting, reshape via SMASectomy/SMAS-stacking plication, and redrape skin), duration between procedures, concurrent procedures, and complications.

What was found

The average duration between primary and secondary face lift was 9.0 years, and between secondary and tertiary procedures was 7.5 years, showing no difference in longevity (p = 0.2). Complications among the 60 secondary procedures included one seroma (2 percent), one skin slough (2 percent), and one temporary marginal mandibular nerve injury (2 percent). Revisions included one neck, one earlobe, and one preauricular scar.

Why it matters

This study provides procedural duration and safety data for secondary rhytidectomy, suggesting that repeated face lifts can achieve longevity comparable to primary procedures when addressing altered anatomy.

Limits

The study is a single-surgeon retrospective case series without a randomized control group. The sample of secondary (n = 60) and tertiary (n = 10) procedures is small, and aesthetic outcomes or patient-reported satisfaction measures were not reported in the abstract.

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