A doctor mentioned a short scar facelift. Please describe this procedure and how is it different from a traditional facelift? Also, is it true that in a traditional facelift, they actually lift the skin and re-drape it after stapling underlying tissue? Is it true that they have to put screws in the skull as well? Please explain this procedure.
Please Describe the Short Scar Facelift
Doctor Answers 25
Short Scar Facelift
The differences are significant. The idea of a facelift with a ‘short scar’ appeals to the consumer, but the term is quite misleading. It leads one to believe that you can get the same result with a shorter scar, and the reality is that you can’t. It sounds too good to be true, and it is. In fact the logic behind these procedures really defies logic.
The ‘short scar’ and MACS facelifts eliminate the incisions behind the ears, which – if carried out correctly – should result in invisible scars. Scars behind the ears, when placed where they belong (in the depth of the crease behind the ears and hidden in the occipital hairline) are either invisible or very difficult to detect. So why all the fuss? Because a lot of surgeons are not meticulous about making and closing the incisions behind the ears, which has given these scars a bad name. But there is no reason it has to be that way.
Hey, what are those odd scars in front of your ears?
The MACS facelift moves ALL of the skin excision into the area in front of the ear, which forces the surgeon to create a gathered, pleated and essentially impossible-to-conceal closure around the patient’s sideburns. With a traditional facelift closure the scar in this area may be placed behind the temporal hairline, where it is invisible, or at the hairline, where it can be closed invisibly because much or most of the skin excess has been removed behind the ears.
The MACS lift does something that is completely counter-intuitive: moving the surgical scars from areas where they are easily concealed to areas where they are almost impossible to conceal. The term ‘short scar facelift’ is really misleading, as you go from longer scars that can be completely concealed to shorter scars that can’t. So effectively, in terms of visible scars, the ‘short scar’ facelifts are in reality LONGER VISIBLE SCAR facelifts.
They are also - as they undermine less skin and undertreat or completely fail to treat neck skin laxity - less of a facelift. And not really a necklift at all, which all facelifts should be.
Um, your neck still looks old.
There’s just no way around it. In patients with neck skin laxity, if you fail to fully mobilize the skin of the neck as well as below and behind the ears, then it is physically impossible to create a smooth, dramatic and truly rejuvenation neck contour. Unless, as a cosmetic plastic surgeon, you are willing to leave a pile of skin folds and pleats in the lateral neck below the ear. I have yet to meet the patient who will be happy with a sort-of youthful anterior neck but an aged and post-surgical looking lateral neck. And I would derive no joy from providing a patient with that kind of surgical result.
Spend some time carefully studying ‘short scar’ facelift (‘MACS lift’ ‘S-lift’, ‘weekend facelift’, ‘Lifestyle Lift’, etc.) before and after photos. You will see, over and over, the following features:
Easily visible scars in the sideburn area and in front of the ears
Distortion of normal sideburn anatomy
Gathering of skin (pleats and wrinkles) below the ears
Undesirable skin contours below the jawline and in the neck
Little to no improvement in neck skin laxity
f course you may also see unfavorable scars in traditional facelift ‘before and after’ photos, so you need to carefully research the physician or physicians you decide to consult with for a facelift procedure. If a surgeon has mastered the High-SMAS face and necklift procedure, the scars should be close to invisible and often undetectable. This procedure, combined with structural fat grafting, rejuvenates the face in a very dramatic yet still very natural-appearing way. And with scars that allow a patient to wear their hair any way they please, including pulled back in a ponytail or gathered up above the ears.
Short Scar Facelift
Short scar facelift has its place in the aging face surgeon's tool box. The key here is to determine if you are a proper candidate for such a lift. The scar provides access to the face for the lifting portion. In some patients, especially those with a large amount of neck skin, the short scar lift may not be the best option.
While the short scar provides access to the face, the underlying technique of lifting the face should still focus on lifting the deeper tissues of the face into a better position.
For more information on short scar lifts, see link below.
Short scar facelift usually means short recovery time
The short scar facelift or mini lift can produce substantial and lasting improvement for appropriate candidates, and has the advantage of a short recovery time as well. Because the incision and operation is shortened there is less swelling and bruising and recovery can be shortened to several days rather than a week or longer. The short scar facelift works well for individuals with moderate laxity in the neck and jowl.
Age, in fact, is not the limiting factor as we all age differently, though a very loose neck, a dreaded turkey neck, will most often require the full facelift approach. The full facelift differs in that the incision runs up behind the ear into the hairline in back which allows a very full correction of the neck when needed.
The key to facial rejuvenation is safety, substantial improvement, with a manageable recovery, and in this day and age a short recovery is a must.
Best of luck,
Peter E Johnson MD
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Variations of Facelift Surgery
There are multiple facelift options available to treat the various manifestations of facial aging. It’s important to realize that each of these techniques offer unique advantages and disadvantages. The best results occur when the best option is chosen for any particular deformity. Some of the options available include the facelift, short scar facelift and mini facelift.
The facelift has many variations that are used to reverse the changes associated with facial aging. These techniques have several features in common. They all address nasal labial folds and loss of definition of the jaw lines and jowls. In addition changes in the neck are addressed as well. The procedure removes excess fat, corrects muscle abnormalities, and removes excess skin in the neck. The procedure is associated with high satisfaction rates.
Mini facelifts and short scar facelifts utilize many of the same principles as full facelifts, but are far less aggressive procedures. Once again, there are multiple variations of this type of procedure. These procedures are associated with fewer complications and shorter recoveries. With these procedures, the neck is minimally impacted and the primary focus is the jaw line and nasal labial folds.
Staples and screws in the skull are commonly used with endoscopic browlift, but aren’t used with facelift procedures. It’s important to realize that each of these techniques has a role in facial rejuvenation surgery. It’s critical that a proper analysis be undertaken to determine which option is best for any particular patient.
Short Scar Facelift - Mini-Lift?
A short scar facelift means different things to different surgeons, has many variations and is called by a multitude of names including: Mini-Lift, MACS lift, Limited Scar Lift, Short Scar Lift and a multitude of marketed branded names and trade name lifts. What the variations have in common is a shorter length incision than in a standard or full facelift, which usually avoids a scar behind the ear. The position and length of the incision depends on the extent of the procedure, the patient’s individual anatomy and the surgeon’s preference. Beside the length and placement of the incision, what may vary significantly from surgeon to surgeon is the extent of the lifting of the skin from the underlying tissue and the amount and method of correction of the underlying tissue, which may be sutured, not stapled.
It is a good technique that I and many plastic surgeons will utilize in the appropriately selected patient with early aging without extensive skin laxity of the jowls or neck or for patients who have had a prior facelift and would benefit from a little freshening. It is not
an option for all or even most patients with greater tissue sagging who would get a better correction with a full facelift.
Staples are not used in the underlying tissue, but small skin clips or “surgical staples” may be used in the scalp portion of the incision. Screws to help stabilize the tissue to the scull are not used for a facelift. Some surgeons, but not all or even most may use them
in a brow or forehead lift.
What is more important than opting for a particular technique, is choosing an experienced artistic plastic surgeon. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.
Robert Singer, MD FACS
La Jolla, California
Short Scar Facelift
The short scar facelift refers to a shorter length of the incision behind the ear, which allows more freedom in wearing your hair back or cut short. The correction of the underlying tissues can be done through a short scar approach just as it can with a longer scar. It is important to discuss with your surgeon what his or her technique is. For a brow lift, which some patients refer to as an “upper facelift,” fixation of the tissues can be done utilizing a screw, but there are other techniques as well. Staples are often used for incisions at the hairline, because less hair is caught in the incision, but these are removed within a week of surgery.