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Why Do Surgeons Choose One Incision Technique Over Another?

asked 3 months ago by Mal
Latest answer by Amiya Prasad, MD
Question viewed 299 times
Tags: comparison, incision, technique

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?

20 answers to Why Do Surgeons Choose One Incision Technique Over Another?

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Technique for Facelift Incision

Each patient is unique and requires a customized approach to achieve their cosmetic goals. After some time, I found that patients who sought a face lift had hesitance because they didn’t want to appear unnatural or show obvious signs of surgery. Patients also did not want the long period of recovery and did not want an ineffective “short cut” procedure. So, I have developed the Quick Recovery Facelift at my practice in New York, based on years of experience with... more
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Facelift incision

At the temple/side burn - just inside the hairline so hair grows through the scar, wavy so replicates natural hairline At the upper ear root of helix - same width as the helix then intraragal (at the tragal edge) preserve the incisur Post auricular then across the mastoid skin at the level of the tragus or higher Then into the posterior scalp (and preserve hair) I have found these to provide... more
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A Tailored Approach is Best

The best thing is to evaluate the patient and customize the procedure to the patient's problems. That said – we have been using the hairline scar much more frequently as it really gets the lower neck pull.
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Face lift incisions need to be customized

There should be no standard face lift incisions that fits all since each person has a different anatomy,hair-line, and hair density. I always customize the incisions to the specific needs of the person. Some are placed in front of the hairline and some in the hair-bearing scalp.
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Hair line incision for facelift

The location of the upper part of a facelift incision can be changed to different locations to get the best results. One of the down sides to placing the scar in the hair-bearing scalp is that once in a while hair doesn't grow in the scar and it is noticeable. Also, sometimes the fine hair in front of the ear gets stretched behind the ear. This is a tell tale sign of an amateur facelift. A well done hair-line incision is natural and doesn't change the... more
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Incision placement varies with facelifts

The short answer - each surgeon places the incision where her or she believes they can obtain the best results, with the fewest negatives for the patients. Hairline incisions can be more visible initially, and more of a problem if they don't heal well, but leave the pre-existing placement of the temple/sideburn hair and hairline behind the ears unchanged. Incisions going into the scalp are better hidden, but carry a much higher risk of changing the patient's hairline design... more
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Incision Techniques in Facelift Surgery

Incision location in facelift surgery should vary depending on the needs of each individual patient. Proper selection of these Incisions should provide maximum improvement and maintain normal hair distribution which will frame the face and provide freedom of hair styling after the operation.. Many factors besides incision location determine the longevity of the result.
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Why Do Surgeons Choose One Incision Technique Over Another?

Plastic and cosmetic surgeons perform things differently during a Face Lift just like bakers make chocolate cakes slightly differently. This shouldn't surprise anyone but should be expected and anticipated. I haven't make face lift incisions within the hairline for about 7 years and don't even extend face lift incisions above the ear. Each Face Lift Surgeon has his/her way of performing the surgery. Techniques however are secondary, in... more
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Why Do Surgeons Choose One Incision Technique Over Another?Answr:

There may be several factors affecting incision placement...One is personal preference....Doctors get used to certain incisions usually a result of trial and error in their hands over years...But the other factor is that certain patients have certain anatomy and someone with a very high hairline may need an incision at the border and someone with a very low line can have it placed back farther...And then there is patient preference!!!
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Why Do Surgeons Choose One Incision Technique Over Another

Placing the incision in the hair bearing scalp can eliminate the hair at the side burn if there is a lot of skin to be lifted and removed. In those cases, in order to not have that hair loss at the temple, which is an easy tell-tale sign of a facelift, the incision is made in front of the hair. The length of time the lift will last does not depend on the incision chosen, but what is done under the skin and the quality of your skin and tissues.
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Choosing facelift incision placement

As the others here have mentioned, the choice of incision placement should really be customized with each patient. Facial plastic surgery and facelift surgery is not a one size fits all endeavor. Factors to take into account when planning incision placement include; Extent of tissue laxity Hairline location, hairstyle, hair color/thickness - you have to be careful not to further elevate the hairline in patients with pre-existing high hairlines. Male versus... more
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Incision Location In A Facelift

The choice of incisional placement in facelifts is based on a variety of factors including the patient's facial aging anatomy, age of the patient, hairline location and hairstyle and surgeon preference. There is no single best way to do a facelift or locate the incisions. Each patient must be done on an individual basis taking into account all of these factors. There are advantages and disadvantages with any incision location around the ear and hairline. In the end, which incisional... more
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Facelift incisions

I agree with Dr. Shafer completely. Facelifts are customized to the patient's needs and condition. There is no one method that should be applied to all patients. That, fyi, is one of many issues with the LifeStyle lift, which is really one size fits all. Incisions within the hair-bearing scalp heal very well and are not visible unless you shave your head.
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Not every thing is as it seems.

There are always scars with facelifts. The issue is how to hide the scars. Incision along the hairline can compress the hair line making it look unnatural. Shifting the incision into the hair-bearing scalp help avoid changes at the most visible location. Yes there can be a little hair loss but the trade off is a very reasonable one. Even beveled incisions that encourage hair growth thorough the incision and this can result in an unnatural hairline due to associated... more
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Choice of facelift incisions

I prefer to use hair sparing incisions whenever possible especially in young people. This allows for future facelifts without significantly shifting the hairline or risking shock loss in the temples. The end of the inciaons in the neck are better chosen above the neck hairline unless there is a very high neck hairline. The long term result does not depend on the choice of incisions. If the temples or the lateral eyebrows need lifting, additional incisions are used with dissection in the... more
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Facelift incisions

My approach to the incision is customized to each individual patient. There is a not a correct answer for the "perfect incision" that is applicable to all patients. Many factors have to be taken into account, including the patients anatomy, height of hairline, procedures involved, previous procedures/incisions, etc. The best thing is to have an in person consultation where you can discuss your goals with your board certified plastic surgeon. Good Luck more
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Facelift incisions vary with the need

The facelift incision can vary to hairline, in the scalp, sideburn sparing, all depending on where the laxity is and the direction of the pull. Individual needs differ and the surgery must adapted. Best of luck, peterejohnsonmd.com
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Placement of incision

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... more
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Incision choices of plastic surgeons

Ideally, your surgeon chooses their preferred incisions based on extensive training and experience and by following their patients closely for years and modifying the incisions as indicated. Also, the specific anatomy of the patient may dictate an incisional choice. What you don't want is a surgeon who bases their incision choice on market pressures such as can be seen sometimes in "short scar surgery" where the scar really needed to be longer for a nice fine... more
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Good Plastic Surgeons vary their incisions

Each patient has an incision style which best suits their needs. Patients who have a low hairline will often do better with an incision that is entirely within the scalp. However patients with a high hairline do better with one at the edge of the hairline so they avoid a bald spot in front of the ear. There are other variables considered as well including: amount of lift needed prior incisions from prior facial surgery shape of the face. etc... more

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