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Options for Correcting SMAS Face Lift Scars?

I had a SMAS Face Lift, Brow Lift, and Liposuction under my chin in June 2008. The scar in front of my ear is perfectly hidden on one side, but is very visible on the other side. What can be done about this? I have been given cortisone injections on my neck and behind my ears because the incision scars were thick. Do I need scar revision or some kind of laser treatment for these scars?

Asked 36 months ago by simplyme in Michigan
Sort 32 expert answers by:
+2

Bad scars after a facelift are very unusual but can be revised.

Do not laser your scars.  It doesn't work.  Bad scars after facelift are frankly rare.   The skin should not be under significant tension after the operation.  If the scars have spread or are thickened after 2 years, you definitely should have a revision. Careful post-operative management should leave you with a good result. I would like to see a picture of your scars.
Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
+2

Scar Revision after Facelift

The best way to improve a Facelift scar depends on the features of the scar. For example: Thickened scar: steroid injection scar excision (surgical revision) (?) laser Widened scar scar excision (surgical revision) Pigmentation bleaching cream laser
Paul C. Zwiebel, MD
Denver Plastic Surgeon
+2

Facelift Scars

A scar revision can be easily performed under local anesthesia by redoing the incision in a more acceptable manner and excision the previous scar.  This will make the side that concerns you match the side you are happy with and give a tiny lift at the same time.
Pradeep K. Sinha, MD
Atlanta Facial Plastic Surgeon
+1

Scars following a SMAS facelift

Facelifts with or without a SMAS plication use the same incisions genenrally, so the scar is unrelated to the SMAS. Scars from facelifts are usually imperceptable. Ocassionally, however, somene will develope an unsightly scar. Forget the laser. The scar must be revised and all tension taken off of the scar closure.This should give you the best chance for a good scar. A post-operative silicone cream or gel may also be a good idea to minimize the scar. Good luck.
Ronald Finger, MD
Savannah Plastic Surgeon
+1

SMAS lift scars are not different from other lifts.

This is just a point of clarification for those reading the answers to your question. You specified that you had a SMAS lift. Most face lifts use similar scar placements and can result in good (usually) or bad scars. I don't want readers to get the idea that SMAS scars are more likely to be bad!
Hugh McLean, MD
Mississauga Plastic Surgeon
+1

Scar after a facelift

Wait a year and simply revise scar with a little tightening if needed. you can do it on both sides at the same time, under local and I don't generally cgarge my pts for the "touch up". don't bother with injections in front of the ear, likewise with lasers. good luck
Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon
+1

Invisible Scars: the holy grail of plastic surgery!

Making scars disappear is the holy grail of plastic surgery - we are still searching for it! Scars that are thick, or "hypertrophic," are problems once they've developed, and patients who develop unsightly scars will likely heal the same way with simple scar revision unless additional treatments are performed. There's no quick fix: waiting 1-2 years, using massage techniques, silicone gel sheeting, or topical creams have good intentions - and they can't hurt - but they... more
Ariel N. Rad, MD, PhD
Baltimore Plastic Surgeon
+1

Bad scars after facelift

Since it's been 2-3 years since your facelift, I'd recommend a surgical scar revision.  Steroid injections are unlikely to work at this point.     Best wishes,
Thomas Fiala, MD
Altamonte Springs Plastic Surgeon
+1

Scar revision can be done with massage or surgery

After steroid injections and vigorous massage fail to improve scars, you may want to consider revision of the scars.  It's hard to give you an exact answer without actually seeing you and feeling the scars.  Either way, make sure you do good scar massage if you go with surgical revision. 
Jeffrey E. Schreiber, MD
Baltimore Plastic Surgeon
+1

Revision of FaceLift Scar

Regarding: "Options for Correcting SMAS Face Lift Scars? I had a SMAS Face Lift, Brow Lift, and Liposuction under my chin in June 2008. The scar in front of my ear is perfectly hidden on one side, but is very visible on the other side. What can be done about this? I have been given cortisone injections on my neck and behind my ears because the incision scars were thick. Do I need scar revision or some kind of laser treatment for these scars?" The treatment would depend... more
Peter A. Aldea, MD
Memphis Plastic Surgeon
+1

How to correct visible SMAS facelift scar on one side.

In your question, you mentioned that the facelift scar on one side was "perfectly hidden," but "very visible" on the other. You also said you were having steroid injections for thick scars on your neck and behind your ears. Clearly, you have a tendency to form thicker scars, but the fact that one side of you facelift healed well means that a good (or better) scar is possible with revision. The causes of thick or widened scars are multiple, but typically... more
Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
+1

Scars after Facelift Surgery

The healing of the scars after facelift surgery does not necessarily dependent on a specific technique of SMAS lift methods utilized. As you have correctly noticed, it is not uncommon for patients to heal better on one side than the other with everything else being equal. Sometimes we try to attribute widened scars to slightly more tension placed on skin tissues, more swelling, sometimes we attribut it to the type of sutures used in a deep layer or within the skin. We... more
Boris Volshteyn, MD, MS
Reno Plastic Surgeon
+1

Both are possible options

Facelift scars can be remedied with scar revision or laser treatment. It's advisable, however, to consult with an experienced facelift surgeon, who has successfully dealt with this problem before. A proper assessment of your skin quality and laxity is paramount in preventing this from occurring again.
Corey S. Maas, MD
San Francisco Facial Plastic Surgeon
+1

Visible Scars Following Facelift

Depending on how visible the scars are, you might need formal scar revision where the old scar is cut out and realigned in a more favorable fashion. Alternatively, you might benefit from undergoing one of many laser treatment options to reduce the visibility of the scar. 
John M. Hilinski, MD
San Diego Facial Plastic Surgeon
+1

If the reason for the scar being visible is loss of pigment, surgery is not the answer.

any patient can have a scar that is visible because its color is lighter than the surrounding tissues. These patients do best with scar blending by tattoo. We have for years had this resource in our office because it is an effective, inexpensive, no down time technique for scars in all parts of the body. However, if the scar is lumpy or depressed, it will not work. Dr. Mayl Fort Lauderdale
Nathan Mayl, MD
Fort Lauderdale Plastic Surgeon
+1

Scar revision

Nobody is  quite sure why one side would heal well and the other side doesn't. I have performed many vertical Vector SMAS facelifts and rarely this occurs. It sounds to me that a scar revision surgery may be your best bet.
Robert M. Freund, MD
New York Plastic Surgeon
+1

Unfavorable Facelift Scars

If your scars are at least a year old then scar revision is the best options.  I would focus on the most visible incisions (in front of your ear).  Unless the scars behind your ears are extraordinarily thick I would continue to treat them conservatively. Dr. ES
Earl Stephenson Jr., MD, DDS
Atlanta Plastic Surgeon
+1

Many options (time, topical scar treatment, revision) for improvement in facelift scars

There are many options for improvement in facelift scars. Time is probably the best/ most effective. Scars mature over a period of 12 months and most scars will lighten and soften during that time period. If a scar is not interfering with a bodily function (closure of the eye, for example) most facial plastic surgeons will wait up to 12 months given how well the body heals on its own. In the meantime silicone gel/ sheet products can be helpful as are topical treatments like Mederma. I... more
Stephen Weber, MD
Lone Tree Facial Plastic Surgeon
+1

Revision of Facelift Scars

Revision of facelift scars should be done cautiously and in the hands of an experienced facelift surgeon.  While it may seem simple enough to just cut a scar and suture it properly, the most likely cause of poor scar formation is excessive tension placed on the incision.  In many cases, the skin must be loose enough to recruit skin posteriorly, sometimes necessitating a revision facelift to adequately lift the deeper tissues. 
Anil R. Shah, MD
Chicago Facial Plastic Surgeon
+1

SMAS facelift scars

The visibility of scars after facelift are usually related to tension in the closure, inflammation around sutures used, or traumatic handling of tissue.  There are some variables that surgeons don't control such as your skin type, genetic pre-disposition to keloids, and a patient's choice to smoke.  In my practice, early scar control is offered with a selection of topical antioxidants to decrease inflammation, surface silicone gels to control exposure, and... more
Randy Wong, MD
Honolulu Plastic Surgeon
+1

Face lift scars

The question has been addressed very well by the expert surgeon posters. You need at the most a scar revision, at the least laser therapy. From MIAMI Dr. B
Darryl J. Blinski, MD
Miami Plastic Surgeon
+1

Scar Revision After Facelift

Scar revision after Facelift can be simple or more complicated, depending on how much tension was placed on the skin, wound complications after surgery, and incision design/ placement at the time of your original surgery.  An evaluation by a board certified Facial Plastic surgeon or Plastic Surgeon will be the most useful way to determine this.
Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
+1

Facelift scars

Since you are over a year out, you probably qualify for a scar revision. Depending on the width and characteristics of the scar, several options may be available. Prior to embarking on a scar revision, I'd make sure that you have maximized all the other options first: massage, steroid injections, silicone, Dermabrasion, IPL, etc. If there is no improvement then a direct scar excision would be the quickest and best solution if the width allows for a tension free closure. If it is too wide, a... more
Edmon Pierre Khoury, MD
Dubai Facial Plastic Surgeon
+1

Scar problems with a facelift

Scar problems form a facelift can sometimes be revised. Usually they can be improved secondarily as the tissue has relaxed and is not under tension.
Steven Wallach, MD
Manhattan Plastic Surgeon
+1

Facelift Scars

Hypertrophic or Keloid scar formation is a risk of any operative procedure - however when these type of scars form on the face, they take on more importance to treat. Generally, I wait 6 to 12 months post procedure before initiating active treatment of the scar. During the first 6 months, if the scar is excessive, I will start an intensive masage program, tell patients to avoid sun exposure and may start silicone sheeting treatment. After 6 months, if the scaring is not severe, I will try... more
Wilfred Brown, MD
Fairfield Plastic Surgeon
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