Purpose: Statistics published by ASAPS report a 25% increase in cosmetic procedures for 1999-2000. Patients 35-50 account for 31.3% of all rhytidectomies performed. It stands to reason that many of these patients will undergo secondary rhytidectomy. The purpose of this report is to examine any differences in secondary (or more) rhytidectomy patients from those undergoing a primary rhytidectomy.

Methods/Techniques: We identified a total of 113 consecutive secondary rhytidectomy patients, of which 101 charts were available for review. 98 were female and 3 were male. Ages range from 40-81 with an average of 60.

Results/Complications: Secondary facelift patients were segregated by age. Of the 101 patients, 53 were >60 yrs of age and 48 were 60<. Of the patients >60, 41/53(77%) had combined procedures with their most recent facelift and 39/53(74%) had at least one comorbid medical condition. There were a total of 67 additional procedures performed in this group of 53 patients or 1.3 additional procedures/patient. Of the patients <60 37/48(77%) underwent multiple procedures along with their most recent facelift and 16/48 (33%) had at least one comorbid medical condition. This same group had a total of 70 additional procedures or 1.5 additional procedures/patient. There were two major complications in patients <60, one consisted of a DVT/PE and the other had a cellulitis. The major complication rate was 2/101(2%).

Conclusion: With advancing age we see an increase in the number of comorbid medical conditions. Interestingly, the overall complication rate in the secondary rhytidectomy patients compares favorably to that traditionally quoted for primaries, who on average, are younger at the time of surgery. Nevertheless, these secondary rhytidectomy patients still underwent additional procedures that did not lead to an increase rate of complications. This suggests that in properly screened patients secondary facelifting even in older patients with combined ancillary procedures is both common and safe.