Stanford Doctors

Why Do Surgeons Choose One Incision Technique Over Another?

Why Do Some Plastic Surgeons Make Incisions in Hair-bearing Scalp when Doing a Facelift While Others Will Make the Incisions along the hairline, but not into the hair? Is there an advantage to making the incisions in hair-bearing scalp (even in a fairly young person without a lot of extra skin). I would prefer NOT to go into hair-bearing scalp, but want a life that will last?

The decision of where to place the incisions should not have a bearing on how long the lift will last. Surgeons will have differing opinions on scar placement based on their experience and training. It is best to ask your surgeon why they would choose the particular incision placement in your case. You want a great result and hopefully your scars will heal in a way that will be hard to see in any location.

I base my decision for scar placement on a few factors.

1/ Your hairline location- Incisions in the scalp can raise the hairline and if your is already high this may not be a good choice.

2/ Skin type- In some skin types hairline in incisions can be more noticeable.

3/ Your hairstyle- Granted this may change but if you wear your hear pulled back a hairline incision may be more noticeable.

In my experience hairline scars can heal very well and be hard to see from conversation distances. While scars in the hair may be covered by the hair sometimes people can have loss of hair along the scar after surgery.

Hope this helps. In the end, I find it best to discuss the trade offs of scar placement in person, and probably best that you do this with your surgeon. Choose someone your are comfortable with that they understand your goals.

David M. Kahn, MD

Palo Alto Plastic Surgeon

Why Are Drains Used in Breast Augmentation?

Hi, I would like to know why some surgeons use drains in breast augmentation while others don´t. Can they cause an infection? Is it better to use them or not? Thank you

For augmentation using smooth implants most surgeons do not use drains. However for augmentations where a textured surface implant will be used a drain will limit fluid around the implant and promote the ingrowth of the capsule into the textured surface of the implant. If there is fluid around the capsule the incorporation of the implant into the surrounding capsule will likely not occur and the implant will behave similar to a smooth walled implant. In this case, one would not gain the benefits of the textured surface which include decreasing the capsular contracture rate and preventing rotation of the implant (important if a shaped implant is used).

David M. Kahn, MD

Palo Alto Plastic Surgeon