In a few days I am scheduled for a facelift revision. My surgeon did a SMAS but did not undermine the neck and jowls so the facelift failed. This time he wants to add a horizontal incision behind my ear along the hairline. He said this time he would undermine my jowls and neck and redo the SMAS facelift and start over. What is this extra incision sight about? This time I want to ask questions and be more informed.
Horizontal Incision Along Hairline Behind Ear
Doctor Answers (24)
Incisions and Facelifts and Questions about Redos.
It sounds like your first face was possibly a little conservative. Your surgeon is very nice to do the second and plan a more complete procedure. The facelift incision behind the ears varies from patient to patient and doctor to doctor. A nicely done hairline incision heals beautifully and defies detection. Alternatives incisions are available, but I am okay with the hairline and sometimes use it myself. The important combo is to have the right incision planed for the right patient. Hopefull your surgeon is certified by the American Board of Plastic surgery and is a Fellow of the American College of Surgeons with full major hospital privileges. If in doubt seek one or two consults with trustworthy local surgeons and see what they say. Sorry your first lift did not work out for you. My Best to you, Dr Commons
Face lift incisions
The incisions behind the ear you are describing are very common and will help your surgeon obtain a better result
Palm Beach Facelift vs Palm Beach Minifacelift
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Incisions placed behind the ear are designed to give access to the tissues of the neck. If you desire improvement to the contour of your neck then an incision behind the ear is appropriate. In general these incisions heal very nicely.
Post-auricular incision & facelift
It sounds like you had a mini facelift the first time, rather than a full facelift. The mini-lift procedure is good for the cheeks, but not powerful enough to address the neck.
Now it sounds like you are getting a full facelift, with the longer incision, extending behind the ear, and into the hairline area.
The longer incision will allow for greater access to the neck and jowl area, better redraping of the skin, and hopefully, a better result for your problem areas.
All the best,
Consider a second opinion
Andrew C. Campbell, M.D.
Board Certified Facial Plastic Surgeon
Incision behind Ear for Facelift
Your surgeon may have initially performed a "mini facelift" or "short scar facelift" which is designed to address the jowls and cheeks but not the neck specifically. By creating a longer incision behind the ear he may be able to better address excess skin of the neck.
Horizontal Hairline incision
As previously mentioned, the addition of the horizontal portion of the incision behind the ear allows for smoother skin redraping of the neck after resuspending the SMAS and platysma muscle. It is very difficult to lift any neck skin in a smooth fashion without this additional incision. It sounds like your first procedure involved some minimal jawline and neck work with more focus in front of the ear.
In order to gain more access to lift the jowels and neck area, an incision is made behind the ear into the hairline or along the hairline. This allows a greater trajectory of pull in those areas. The good news is that the incision behind the ear is usually very well hidden and if done well, the hairline incision not very noticeable. Have your surgeon show you some pictures of scars - that should help you visualize it better.
Dr. Cat Begovic M.D.
I totally agree with Dr. Rand. Incisions are entry points to mobilize your soft tissue. This mobilization allows repositioning of the tissue to a more youthful position, and creation of more youthful appearing features. To achieve harmony of face and neck, both areas need to be repositioned, and underlying structures altered, e.g. muscle and fat. These surgical maneuvers are only possible with adequate exposure, necessitating appropriately positioned incisions.