When the aging process causes the sagging to reappear, a secondary facelift, or facial tuck-up, may be performed. This often provides more dramatic and longer lasting improvement. In some individuals, it may be necessary to perform this procedure as soon as six months to one year after the initial facelift. I may even suggest that a small tightening under the chin may likely be required within the first year to achieve the desired lasting effect. The secondary facelift is recommended for patients who have a severe degree of sagging preoperatively and experienced an accelerated aging process.