It is always hard to judge other surgeons' work based on a photo as one can never be certain of all of the pertinent circumstances.
Nonetheless, I share your concern about the folds, pleats and wrinkles. The will likely improve in time, but I don't believe they will go away entirely - especially the large one behind your left ear.
It looks like these were left in place as "tailoring short cut" to avoid extending the scar more posterior toward the and into the hair.
I find that when surgeons market short scar facelifts, lower facelifts, etc they often sacrifice natural shape, form, contours for shorter scars. When incisions are placed strategically and closed carefully scars are not an issue, they are hard to see. When a the scars are too short and a lot of loose skin is crammed into the smaller dimensions folds and pleats are the result.
Also, for a facelift I generally see my patients at 1-2 days, 1 week, 2 weeks, 1 month, 3 months, 6 months, and 1 year, and beyond that as is necessary or desired. At each time interval I anxiously await the patients return. I love to see how we have done and how patients feel about their results.
thanks for your question. If you were my patient, there is no way I would discharge you at only 12 weeks follow up, in fact my facelift patients are stuck with me for life if they need me. At 12 weeks, your scars are immature, do not worry, they will contract and soften. Massage and/or steroid intrascar injections can help but mainly it is time that is needed. Your jowls 'returning' may indicate normal relaxation of the tissues but a significant worsening of the jowl should be seen by your surgeon. Good luck.
I think that you have a right to be concerned about your scars. While they may improve with time, I do think that your surgeon should see you several times until they are better. Many times steroid injections are required to help soften the scars behind the ears.
First and foremost, I agree with Drs. Bray and Bustillo. Being discharged at 12 weeks is very premature for a Facelift patient, because the healing process is incomplete. Commenting on the quality of scars at this point isn't really fair, because they will look much better with time. If I had to venture a guess, it looks like a short incision mini-lift was performed, which can lead to irregularities where the incision ends. Whether a mini-lift was the right procedure for you at the time is impossible to say over the internet.
Our office specializes in facelift revisions and I was featured on The Doctors demonstrating a earlobe scar repair after a facelift. Treatments are available to improve your scars after facelift surgery.
Raffy Karamanoukian MD FACS
Scars in the post-auricular (behind the ear) area can be irregular, thickened and lumpy.
Much of this can resolve over the 6 month period after surgery.
If they do not smooth out, a touch-up under local anaesthesia can be done.
It looks like your surgeon performed a short scar facelift. In doing so sometimes the skin is tucked behind the ear. Some of this may go away, but my hunch is that you might need an adjustment behind the ear in the future once it has healed.
It is always difficult to assess photos however, I do believe that you should go back to your surgeon to continue care or visit another if your surgeon considers you complete. Have his also reevaluate your lower lids as well. Best to you.