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A 72-year-old woman had a neck lift, lower facelift and liposuction in the neck. After some time, there was a lumpy area under her chin. She continued to have jowls, lines in her nose and mouth, and neck wrinkles were reappearing. She asks if she can have her face repaired and if these can all be done as an in-office procedure with the same doctor. Dr. Amiya Prasad, an oculofacial cosmetic surgeon, says that there appears to be a regression and a collection of extra skin below her jawline, so she clearly needs some revision in order for her to look good. This phenomenon depends on factors such as skin elasticity. Unfortunately, he can't do a proper assessment with only the photos she has sent. It's important to have a physical exam to make decisions about the level of surgery and the extensiveness of the procedure. When he does an examination, he lifts the skin to look at how much lifting needs to be done and where the incisions have to be placed. In Dr. Prasad's practice, he does all his facelifts and neck lifts under local anesthesia with sedation. That means getting an IV, some liquid valium and propofol, and then the patient can be relaxed throughout the procedure. He has his own facility, so technically it is an in-office procedure. Dr. Prasad suggests that whenever people consider revision surgery with a procedure like face lifting, it's their first doctor who should be doing the revision or enhancement of the surgery. It's because they are already familiar with the elasticity and the quality of the skin, and most of all they know what to expect with your surgery. If all those things feel right with the patient, then they can go ahead and proceed. For more information visit us in our website: http://prasadcosmeticsurgery.com/pras...