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Does Facelift Involve Literally Pulling the Skin to Tighten?

I have scars under my eyes. If I have a facelift, would it mean that the scars could be removed as excess skin as the face is pulled up tighter?

Asked 29 months ago by Graeme S in uk

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Eyelid Scars

A facelift, which lifts the side of the face and the neck, would have no effect on lower eyelid scars. A check-lift, done through a lower eyelid incision, could be used to revise the lid scar if there is tension of the skin on the lower eyelid.

Doctor's Website

Richard W. Fleming, MD

Beverly Hills Facial Plastic Surgeon

Skin Tightening in Facelifts

Modern facial rejuvenation is much, much more than just skin tightening. One can see this in the current franchise and heavily marketed “facelift type” procedures. These procedures are done under local anesthesia and the scar is in front of the ear and the skin is only pulled tightly. This does not last long nor does it look good. True facial rejuvenation is a deep layer manipulation using a “Lift & Fill” technique as aging is both facial skin laxity with facial... more

Rod J. Rohrich, MD

Dallas Plastic Surgeon

ASAPS ASPS

Eye scars being removed during a facelift

The skin that is removed during a face-lift is mostly the skin in front of the ear. I cannot imagine that you have enough loose skin that a scar on or around the lower lid would be remove during a face-lift. If the scar is close to the lash line and you have loose skin of the eyelid, it might be able to be removed using an eyelid incision though.

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Julio Garcia, MD

Las Vegas Plastic Surgeon

ASAPS ASPS

Facelift and Skin Tightening

An anatomically correct facelift is actually designed to lift up the deeper tissues of the face. When the deeper tissues of the face are suspended, the excess skin is removed without tension. While it seems intuitive to just cut and remove skin, the skin only lift will place excess tension on the skin and relies on delicate skin to lift up heavier face tissues. The reason this technique does not work is that ultimately the skin stretches back, leaving the patient... more

Anil R. Shah, MD

Chicago Facial Plastic Surgeon

Facelift tightens the fascia and structures underneath the skin

A comprehensive face/neck lift involves tightening the fascia and structures underneath the skin in the face, the tightening of the muscles in the neck, removal of fat deposits both above and below the muscle in the neck, and then gently removing any excess skin that is present after the muscle and fascial layer has been tightened. It will not affect any scars on the eyelids.

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William Portuese, MD

Seattle Facial Plastic Surgeon

A midface lift could recruit more skin and perhaps allow scar improvement

The typical facelift done to improve the neck, jowls, and cheeks would do little for the eyelid scars. A midface lift, however, done at a deeper level elevates the cheek almost directly upwards and can recruit tissue into the lower lids. This has been well shown by a number of studies including one by Quatela in the Archives of Facial Plastic Surgery. Depending on the situation the scar could then be improved. Various peels and laser treatments could be added depending on the situation.... more

Wayne F. Larrabee, MD

Seattle Facial Plastic Surgeon

Facelift versus lower eyelid scar revision

It depends on how bad the scars appear and other factors such as lid tone, skin excess and the type of facelift you are going to have performed. If, for example the surgeon performs midface/ cheek lift with the facelift a fineline scar revision is certainly possible, but conservative laser resurfacing or chemical peel may do more to correct lower lid wrinkles or loose skin than another skin removing procedure. If there are other eyelid deformities (pseudoherniation, tear trough, hollowing,... more

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Harrison C. Putman III, MD

Peoria Facial Plastic Surgeon

Pulling Skin for a Facelift

It's interesting that you should bring this up. I think that most people believe that this is what we do during a Facelift. In fact the first facelifts were just tightening of the skin. These were okay for the time but plastic surgeons learned that if you don't correct the underlying structure it's impossible to get a good long lasting result. Thus the multitude of facelift procedures that address the SMAS (superficial musculo aponeurotic system). By elevating the SMAS, in some form or... more

Christopher L. Hess, MD

Fairfax Plastic Surgeon

ASPS

Facelfit Procedure

A face lift ideally treats the neck and jowl area. It really does not come close to the lower eye lid region as far as removing skin. Skin is tightened and removed as is the deep layer called the SMAS, which is tightened as well. The skin that is removed is the excess skin around the ears, so there really is not skin removed from under the eye. Depending where the scars are and what kind of shape your lower eyelids are, you may be a candidate for a lower eyelid surgery (blepharoplasty)... more

Farbod Esmailian, MD

Orange County Plastic Surgeon

ASPS

Face lift versus midface lift for removal of lower eyelid skin

Generally a facelift does not pull up the eyelid skin. A midface lift, however, can significantly lift up the eyelid skin and facilitate removal of the lower eyelid redundancy.

Otto Joseph Placik, MD

Chicago Plastic Surgeon

ASAPS ASPS

A facelift is much more than pulling skin

Modern facelift techniques place much more emphasis on re-shaping, tightening, and adding volume to the deeper layer of tissue below the skin. This layer is called the SMAS (superficial musculoaponeurotic system) and is made up of the muscle and fatty layers of the face. This layer is pulled up and, to a variable extent, back in patients. Skin is also removed, and also pulled up and back, but not to the same degree of tightness as the deeper layer. In fact, if significant tension is... more

Sam Jejurikar, MD

Dallas Plastic Surgeon

Does facelift involve literally pulling the skin to tighten?

Hello This topic is one of my areas of focus. Take a look at my other facelift questions. If you have more questions, let me know directly.

Michael Kulick, MD

San Francisco Plastic Surgeon

ASAPS ASPS

Facelift scars

A facelift will pull the skin back and up. If the scars are located directly under your eyes, they may stay in the same positions. However, if they're lower they might move toward your hairline. Talk with your plastic surgeon to determine if the scars can be removed at the time of the facelift. Good luck!

Jeffrey E. Schreiber, MD

Baltimore Plastic Surgeon

ASPS

Face lift pulls tissue to tighten

Yes, to a degree skin is pulled, but more importantly the tissue and muscle beneath the skin is tightened. This deeper layer is the secret to face lift surgery. The covering skin displays what is happening underneath the face. The majority of the pull should never be on the skin layer itself. Face lift surgery has evolved over the years, but still involves tissue repositioning and tightening. Face lift surgery does not specifically involve surgery around the eyes. Eyelid surgery may be... more

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Houtan Chaboki, MD

Washington DC Facial Plastic Surgeon

Facelift will not remove scars under the eyes

Hello Alexander A facial rejuvenation procedure usually involves what is known as a facelift, and sometimes eyelid surgery. Fillers are good adjuncts as well as some form of peel or laser. However, I doubt that any procedure can remove scars under the eyes by pulling skin tight enough. Have a face to face discussion with a board-certified plastic surgeon and they will be able to give you all your options.

Francisco Canales, MD

Santa Rosa Plastic Surgeon

ASAPS ASPS

With Facelifts, the pull should not be on the skin!

Dear Alexander 1, There are many techniques in performing a Facelift. In surgery, whenever there is more than one technique, it is because there is no perfect technique that fits every patient. One thing is certain though, for a longer lasting, more natural result, steer clear of any technique that puts the pull or tension on the skin of the face. All tension should be on the deeper SMAS layer beneath the skin. The scars on your eyelids should not change position with a Facelift. This is... more

Leslie H. Stevens, MD

Beverly Hills Plastic Surgeon

ASAPS ASPS

Does facelift involve literally pulling the skin to tighten?

Does facelift involve literally pulling the skin to tighten?- Only if done poorly. A modern facelift procedure, of which there are many, each with its own indications, has a common theme - the upward repositioning of sagging facial structures and excision of redundant skin along the side burn, ear and occasionally the lower lid. The skin should NEVER be used to do the actual pulling. Doing so will almost guarantee a visible scar widening. Instead, we often use traction and repositioning of... more

Peter A. Aldea, MD

Memphis Plastic Surgeon

ASPS

Facelift is more than pulling skin

Everyone can spot the poorly done facelift by the "pulled" or "wind tunnel" look. Modern techniques focus more on 3-dimensional shaping than on tightening skin, so the look is a lot more natural. I can of course only speculate about how this would affect scars under your eyes, but I suspect that if the skin were to be pulled enough to elevate them then it would probably not be a good look overall.

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Richard Baxter, MD

Seattle Plastic Surgeon

ASAPS ASPS

Facelift Does Pull the Facial Skin

Facelift pulls the skin on your cheeks,chin and neck area upwards and backwards. If there is a scar on your chin or cheek it will also move up and backwards. However, the move is not drastic and should not effect the final result. Regards

Tanveer Janjua, MD

Bedminster Facial Plastic Surgeon

Facelift will very likely have minimal effect on scars under eyes

Dear Alexander Facelifts do remove some skin. However, think of it as a small but important strip of skin. So the effect on a scars that is present under your eyes is very likely to be minimal. However, the surgeon who performs your facelift might be able to offer you some help with these scars either in the form of scar revision or some type of skin resurfacing to improve this issue. If it is really the scars that bother you, consider consulting a cosmetic surgeon just regarding this issue... more

Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon

Not Likely

Hi Alexander, Facelifts have incisions that extend along the front of the hairline and ear and then behind the ear into the posterior hairline. The length and exact location of this will vary from Patient to Patient and technique to technique. This is important for you to know since the "extra" skin that is removed during a facelift is removed from along the incision line. A facelift incision should not extend to the scar under your eyes! You would probably be better served with... more