This lady has had a previous facelift performed elsewhere many years ago and has been referred for revisionary facelifting. She is currently been taking oral steroids and the pros and cons of revisionary facelifting need to be discussed and all other options explored. With oral steroids patients often develop increased fullness in the jowls and necks and the jowls are heavy due to a number of factors. This lady required reopening of the previous incisions and repositioning of the internal SMAS with lateral platysma tightening. Although liposuction has been performed to the jowl also not all the heaviness in the jowl can be reduced in patients such as this
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