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�� How to Prevent and Treat Complications in Facelift Surgery Part 2: Long Term Complications
Viren Patel, R'ay Fodor, Anthony Deleoniubs, Max Mandelbaum, Neel Vishwanath, Pierce Jansen, Nicholas Sinclair, James Zins
Cleveland Clinic
2026-01-19
Presenter: Viren Patel
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The program director is responsible for making a statement within the confines of the box below specific to how much of the work on this project represents the original work of the resident. All authors/submitters of each abstract should discuss this with their respective program director for accurate submission of information as well as the program director's approval for inclusion of his/her electronic signature.
Director Name: Raymond Isakov
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Background
Facelift surgery is a widely used and effective treatment for facial aging. This study serves as a companion to prior work by our group addressing short-term facelift complications and focuses on long-term complications.
Methods
A review of the literature on long-term facelift complications was performed and supplemented by the clinical experience of the senior author (J.Z.) to identify adverse outcomes and management strategies.
Results
Ten long-term complications following facelift surgery were identified. Platysmal banding was the most common reason for reoperation, with reported incidence rates as high as 30%. Management strategies include revision midline platysmaplasty or denervation of the platysma via transection of the cervical branch. Cobra deformity was identified as the second most common long-term adverse outcome and was found to be multifactorial, involving progressive soft tissue laxity and contour irregularities. Recurrent nasolabial folds and jowls represented the third most frequent indication for revision surgery and were sometimes associated with prominent submandibular glands; partial gland resection has demonstrated reliable and durable results. Additional complications related to aberrant healing include pixie-ear deformity, loss of tragal definition, and hypertrophic scarring. Although these outcomes may not be entirely preventable, risk can be reduced by minimizing closure tension, avoiding excessive skin resection, and careful incision planning.
Conclusion
Facelift surgery is a safe and effective treatment for facial aging; however, long-term complications remain a concern and are most often related to aesthetic dissatisfaction rather than functional deficits. Some outcomes reflect continued soft tissue aging and are difficult to prevent, whereas others may be mitigated through patient selection and refined technique.
