Objective. To determine the optimal surgical approach for patients undergoing secondary correction of age-related facial changes.

Material and methods. The authors present two patients who underwent secondary facelift surgery in 2024–2025. Technique of wide dissection of skin flap and superficial musculoaponeurotic system (SMAS) is described.

Results. Redo surgeries presented technical challenges due to prior procedures including fibrosis in the areas of baseline dissection, impaired tissue vascularization, deformation of cutaneous and aponeurotic structures. Nevertheless, adherence to the principles of layer-by-layer dissection, precise SMAS repositioning and consideration of anatomical and functional features provide favorable aesthetic outcomes. There were no early or late postoperative complications.

Conclusion. Secondary facelift requires an individualized approach with analysis of fibrosis, scar tissue topography and vascular network. With appropriate extent and surgical technique, it is possible to achieve predictable aesthetic results even in difficult clinical scenarios.

Keywords. secondary facelift, surgical correction of age-related changes, SMAS, platysmaplasty, fibrosis, aesthetic surgery