Hello, Thank you in advance for taking the time to answer my question. I would like to have a second facelift and I'm wondering if it's possible to use the same area (scars) for incisions? My concern is that with age my hair seems to be thinning quite a bit and I'm worried about losing more hair where new incisions would be made. Question 2... is it at all possible to do a mid FL without incisions behind the ear? Thanks again, you guys are great!
Scars for Second Facelift
Doctor Answers (28)
Scars for a Second Facelift
Incision placement is a very important aspect of Facelift surgery, so the question is a very good one. The answer is that good Facelift Surgeons will place incisions in the least conspicuous location possible and avoid excessive skin tension. Excess skin tension can lead to widening or migration of scars from the planned location. Poor incision placement is sometimes correctable and sometimes not. Therefore, the answer depends on whether the incision placement was appropriate, whether the direction (vector) of pull was correct, and whether a SMAS based procedure was performed or not. Consultation with a good Facelift Surgeon in your area will help you determine this.
Scars for secondary facelift- how to minimize
Not only is it possible to use the existing scars for a secondary facelift, it is almost always possible to improve them vastly.
The change in direction of pull can yield a less pulled look. The "high on the side" or Nike swoop look can be reversed.
Reconstructing the earlobe and tragus can hide scars and yield a more relaxed look- despite things being rejuvenated.
Hairlines in the temple and posterior ear region can be greatly impvored as well.
Brows can be adjusted down rather than further elevated.
Cheeklifts can elevate the middle of the face, not just the side. They can also correct eye shape that has been distorted from conventional lower blepharoplasties.
Times change, and the secondary facelift is the time to update the technique, not just pull tighter. However each of these steps above demands a specific plan.
There was a question on the plastic surgery board examination two years ago for which the correct answer was that a secondary facelift results in further distortion of the hairline. However, this is wrong. The secondary facelift, in highly skilled hands, is the time to update previous techniques.
Redo Facelift Scars
Yes, it is possible to use your previous face lift scars if you have a revision or redo facelift.
Depending on the type of face lift you had before (mini face lift, mid face lift, full face lift), and the type of redo facelift you require, your plastic surgeon may need to use the entire length of the previous incision or just a portion.
A mid face lift or cheek lift can usually be performed through the incisions in front of the ear and do not require incisions behind the ear.
The best way to avoid thinning of hair at face lift scars is to avoid tension on the closure. Thus, it is important to have your surgery performed only by a plastic surgeon certified by the American Board of Plastic Surgery who are trained in these techniques.
Jaime Perez, M.D.
Face Lift Specialist in Tampa, Florida
Plastic Surgery Center of Tampa, Florida
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A facelift can be redone using the same incisions. The incisions can be modified to avoid loss of the hairline as well.
Re-do facelifts re-do the scars
To re-do a facelift, in most cases your old scars will be removed and re-done. By the right doctor and not under too much tension, they might be even better than the first time.
Mid facelift can be done without incisions behind ear and a secondary facelift can be done through old scars
Typically a secondary facelift is done by placeing incisions just behind the old facelift scars so that the old facelift scars are removed.
A mid face lift can be done through incisions inside the front hairline and only the incsions in front of the ear. There is no need to make an incision behind the ear to do a mid facelift
Secondary facelift scars can be well hidden
The scars from your first facelft, as long as they were placed in the appropriate position, can usually be removed during the secondary facelift. This would leave you with a single new scar which should be very well hidden in the normal creases and contours of the face and ear. To avoid pulling your hairline / sideburn backward, the incision can be placed in front of the hairline. As long as this incision is closed meticulously it should be barely noticable. The mid facelft incisions are typically placed in the temporal hairline, through the lower eyelid or intraorally so no incisions behind the ears are needed. Only your plastic surgeon, who has had a chance to examine you, could tell you whether you would need an incision behind your ear to give the best possible result in contouring your neck.
Yes it could be done
It is hard to say 100%. Generally, a mid face suspension or lift during a secondary facelift could be done with anterior scars only. I try to hide the scars behind the old ones by removing the old ones. It will curve the front of your upper ear border, go inside the tragus cartilage and then step anterior to the lobule. If the neck is good, you could have a nice result.
What to do with a secondary facelift incision.
Good question: During your secondary facelift similar patterns of incision are made. This helps to remove the old scars and possibly improve them. In regard to just doing a mid facelift without neck lift, it is possible. I would recommend you to talk to your surgeon. He or she can assess your facial anatomy and decide what approach is best for you.
Secondary facelift and scars
Secondary facelifts are usually performed using the same incisions or changing them to be more hidden, if need be. The one caveat for a re-do facelift is the strong probability that the sideburn will be taken higher, thus giving a somewhat bizarre, aged look. I suggest to my patients that we change the scar to go in front of the hairline/sideburn so as not to produce this deformity. Performed correctly, and meticulously, these scars heal and fade extremely well.