title: Avoiding the operated on look in multiple face lifts.
abstract: OBJECTIVE
  Reviewing 43 patients of ours who have had three or more face lifts, we wanted to demonstrate that it is possible to avoid the multi-operated on look.
  
  
  METHODS
  Forty-three patients have been operated on three times or more: 42 females and one male. Thirty-six patients had three face lifts, six had four face lifts, one patient had five face lifts. The mean age at time of surgery was 50.3 years for the first face lift, 56.7 for the second, and 64.2 for the third face lift. These patients were operated on by the same surgeon using a technique which has evolved over the years but with the same basic goal of hiding the scars and of minimising hairline displacement. General appearance, scars and hairline displacement were evaluated in patients who had had three or more face lifts.
  
  
  RESULTS
  The results of the evaluation of our 43 multi-operated on face lift patients were as follows: 35 patients did not appear to have had face lifts, eight patients did appear to have had face lifts, but with satisfactory appearance, 30 patients had no visible scars at a conversational distance, 10 patients had slightly visible scars when their hair was lifted, five had obvious scars when the hair was lifted, 34 patients had a normal hairline, six patients had a slightly receding hairline at the temporal level and three had hair loss at the level of the temporal scar.
  
  
  CONCLUSIONS
  New technical improvements allow the preservation of a natural appearance, with well-hidden scars and a well-placed hairline. The common opinion that several repeated face lifts should be avoided because they give an unnatural appearance and severe sequelae in terms of scars and hairline displacement has not been confirmed by our clinical experience with 43 patients having undergone at least three face lifts.
authors.affiliation: danielmarchac@hotmail.com
authors.forename: Daniel
authors.initials: D
authors.lastname: Marchac
authors.forename: Marwann
authors.initials: M
authors.lastname: Nasr au lieu de Nask
mesh_terms: D002921:Cicatrix / Q000473:pathology / Q000517:prevention & control; D004954:Esthetics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation / Q000379:methods; D015361:Rhytidoplasty / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome