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 (40)

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.

New York Plastic Surgeon
4.5 out of 5 stars 18 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 162 reviews

Facelift Scars Two Years Out


Something can always be done to make scars less noticeable. In this case, the trick to revising scar in front of the ear and leaving imperceptible scars is to have enough skin to cover the area left by the excised original scar and closing the advanced skin under little tension. At 2 years out from a facelift, there should be enough laxity of the skin in front of the scars to allow coverage of the area of scar to be excised.

Richard Parfitt, MD
Madison Facial Plastic Surgeon
4.5 out of 5 stars 16 reviews

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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

Kamran Jafri, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

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.

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 3 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 47 reviews

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!

Brian Howard, MD
Alpharetta Plastic Surgeon
4.5 out of 5 stars 18 reviews

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.

Michael Sundine, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 15 reviews

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.

E. Ronald Finger, MD
Savannah Plastic Surgeon
5.0 out of 5 stars 33 reviews

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
4.5 out of 5 stars 4 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.