SMAS Facelift: Q&A
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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?
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37 Doctor Answers |
Asked by
simplyme
in Michigan
+2
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.
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Correcting Scar After Facelift
It may be best for you to have scar revision with meticulous postoperative observation. It is also a good idea to make sure that any areas of redness are treated with 5FU so that you may see optimal results.
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Scar revision of a facelift scar that is thick and red
Scar revision surgery + a combination of fractional co2 laser and pulsed dye laser will help the scar. I have performed both surgical and non surgical treatments with great success.
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Scars After Facelift
In your case, a scar revision is needed and can typically be done under local anesthetic in your surgeon's office. The most important aspect of this is to have absolutely no tension on your scars when they are repaired, and you are not likely to have this problem again. Best wishes!
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Scars after SMAS Face Lift
At two years postoperatively it is highly unlikely that anything other than a scar revision is going to improve the quality of the scars. Laser treatments have not improved the quality of scars in my experience.
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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.
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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!
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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
Boca Raton Plastic Surgeon
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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...
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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,
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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.
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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.
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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
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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...
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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...
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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.
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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
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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.
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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
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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.
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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
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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...
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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.
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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...
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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
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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.
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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...
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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.
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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...
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Hypertrophic scars can occur after facelift surgery
Hypertrophic scars can occur after facelift surgery whatever type of facelift be it a smas lift or deep plane lift type of procedure. The best way to treat them initially is with steroid injections done in conjunction with vascular laser treatments. If after a year or so, they are still visible the best option is a surgical correction to excise the scars and close them with less tension. I would still follow them closely during the healing process and treat them preventively with steroid...
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Scars May Be Revised
There are many options for scar revision after facelift surgery. Sometimes, waiting is the best option as time will take care of a lot of irregularities in scars. For some patients, reexcision of the scar is appropriate while other may benefit from steroid injections or laser treatments. Meeting with a facial plastic surgeon or plastic surgeon to discuss your options would be best.
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Scar revision is a great way to improve your scars
There are many options to improve your scars depending on how the scar looks, how wide, etc. If the scar is large and wide you may need to have it excised first and then have the remaining appearance of the scar resurfaced with dermabrasion and laser resurfacing to make it look even better. There are ways to improve it so that you can basically have a hard time seeing it.
Sometimes the scar is under tension and just regular excision and closure is not enough. I have employed smas techniques...
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Scars can be revised
The scars from the facelift can be revised, but one needs to wait at least one year after the facelift before attempting any revision surgery. Cortisone injections into the scars will help soften them up in the interim phase of the first year prior to embarking on any further revision. If they are truly keloid or hypertrophic scars, an injection of cortisone immediately in the postoperative period will help prevent them from recurring.
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Wait for one year, scar revision might be needed
I would wait for at least one year from the time of surgery. If there is enough laxity, the scar could be revised. Sometimes a deep plication might need to be redone to accomplish a no-tension closure.
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If you have a little laxity the scars can be revised
Many things can be done to improve this. Time, massage, injection of steroids, IPL treatments can all make this somewhat better but not like your other side. The only way to really help the problem is to excise the scars and re-elevate the skin and close it under zero tension. This requires some laxity in the area to work with. If there isn't any laxity, doing a revision now will potentially result in even worse scars and you would be advised to wait a few years until sufficient laxity...
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Face lift scar can be excised and a better scar created
From what you have said it sounds like the "bad" scar is too wide or raised. It therefore shows. This can be removed and a new scar created with sutures below the skin to remove tension on the skin which often makes "bad" scars.
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Facelift Thick Scars treatment: Inject within first year and do surgical revision after 1 year
My experience with scars in general (would also apply to SMAS facelift scars) over the past few decades is that Thick ropy scars (hypertrophic or keloids) that do not respond to topical scar maturation treatment or silicone patches often respond to steroid +/- 5-FU injections within the first year. After one year it is probably best to do a scar revision.
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