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?

Doctor Answers 43

Scar Revision first followed by kenalog / lasers

At this stage it will probably be best for you to have a scar revision procedure done. While this is a surgical approach it is not as intensive as having a facelift done.

It will be important for your surgeon to create some laxity under the skin surrounding the scar so as to minimize tension as it heals. 

Close followup will be important after the revision as kenalog injections, lasers or silicone sheeting can be used to help the healing move along well.

Wishing you well,

Dr. J


New York Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

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.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 63 reviews

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
5.0 out of 5 stars 1 review

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 may be ineffective in the long term. However, scars that stand out from the surrounding skin can be made much less noticeable through laser therapy. Depending on the appearance of your scar, laser treatment can address unwanted pinkness or pigmentation of the scar, and can smooth, soften, and flatten the scar, as well. One thing is for certain: be sure to seek out a board-certified dermatologist or plastic surgeon with extensive experience specifically in scar treatment - gentle energy settings need to be used in treating scar tissue so as not to re-trigger the skin-healing response that initiated the scar formation in the first place. This can be as much an art as a science.

Ariel N. Rad, MD, PhD
Baltimore Plastic Surgeon
5.0 out of 5 stars 29 reviews

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
4.5 out of 5 stars 16 reviews

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
5.0 out of 5 stars 25 reviews

Options for correcting SMAS facelift scars?

Hello! Thank you for the question! It is common for scars to fully mature for up to a year. In the meantime, there are a few things that may help to ameliorate your incision/scar. The most proven (as well as cheapest) modality is simple scar massage. Applying pressure and massaging the well-healed scar has been shown to improve the appearance as it breaks up the scar tissue, hopefully producing the finest scar as possible. Other things that have been shown to add some benefit, albeit controversial, are silicone sheets, hydration, and topical steroids. In addition, avoidance of direct sunlight to the incision will significantly help the appearance as they tend to discolor with UV light during the healing process.

If unsightly scars are still present after approximately a year's time, other things that your surgeon may consider are intralesional steroid injections, laser, or just surgical revision of the scar itself.  It appears as if nothing beyond scar revision is the best for you. 

Hope that this helps! Best wishes!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 14 reviews

Facelift Scars

Thank you for your question. Scars following a facelift should be totally faded by 12 months. If you still are concerned at 6 years, it is probably worth seeing a surgeon for a scar revision. It might even give you an opportunity to do a limited enhancement of the original procedure. Good luck. 

Steven L. Ringler, MD, FACS
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 39 reviews

Scar revision for SMAS Facelift

Scar revisions are quite commonly needed for SMAS plication lifts and are very very easy to perform in most cases just using local anesthesia.  The options are scar excision, steroid injections, laser resurfacing, skin flap movement and even hair transplantation.  

The type of revision needed just depends on how the scars look and where they are located. 

Ben Talei, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

Very peculiar

The healing rate of one side over another might be due to a condition, or even to just the environment there are way too many factors to judge at this point, It would help if you sent us some pictures that we might evaluate and come up with a more powerful solution.

Jonathan Fisher, MD
Miami Plastic Surgeon
4.5 out of 5 stars 575 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.