title: A comparison of primary and secondary rhytidectomy results.
abstract: BACKGROUND
  This study aimed to evaluate the authors' surgical experience with secondary rhytidectomy and to compare these results with those for primary rhytidectomy patients.
  
  
  METHODS
  A retrospective review of patients who had undergone secondary rhytidectomy was performed. In addition, an equivalent number of primary rhytidectomy patients were selected randomly. Data were collected evaluating patient age, time elapsed between rhytidectomies, type of procedure performed, superficial musculoaponeurotic system (SMAS) thickness, amount of skin resected, complications, adjunctive procedures, and patient satisfaction.
  
  
  RESULTS
  This study enrolled 21 secondary rhytidectomy patients. The average time elapsed between their previous and last rhytidectomy was 9.95 years. Using a grading scale of -4 to 4, the average SMAS thickness was 2.2 for the primary and 0.67 for the secondary rhytidectomy patients. The average skin resection was 26.6 mm for the primary and 17.6 mm for the secondary rhytidectomy patients. The complications for secondary rhytidectomy included one hematoma and one hypertrophic postauricular scar. The follow-up period ranged from 6 months to 7 years. All secondary rhytidectomy patients expressed satisfaction with their overall aesthetic result.
  
  
  CONCLUSIONS
  Secondary rhytidectomy is a safe and effective procedure for the aging face. The SMAS of older patients appears to be thinner and more delicate and therefore must be handled with care. Additionally, skin resection is significantly reduced compared with that for primary rhytidectomy patients.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Canada. etaifunk@yahoo.com
authors.forename: Etai
authors.initials: E
authors.lastname: Funk
authors.forename: Peter A
authors.initials: PA
authors.lastname: Adamson
mesh_terms: D000328:Adult; D004954:Esthetics; D005145:Face / Q000601:surgery*; D005152:Facial Muscles / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012060:Rejuvenation; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D015361:Rhytidoplasty / Q000379:methods*; D013524:Surgical Flaps