I had a face lift 8 months ago and have developed some scar tissue around my ears at the bottom of the earlobe. I have had 4 cortizone shots to try and reduce/flatten this area and it has only helped a little. I have also tried silicone sheeting and several scar therapy creams with no success. What are my options at this time? Is additional surgery my only option? Where I have developed the scars is very sore and tender.
Best Treatment for Scars After Face Lift
Doctor Answers (9)
Face lift scars at 8 months
As long as there is enough laxity it is probably best to remove the old scars and take a number of steps to make sure the new scars heal better:
- Having minimal tension on the wound
- Using minimal dissolving sutures
- Using topical silicone gel and tape on new scars
- Injecting the scar at the earliest sign of thickening
Hyperthrophic Scars are what you have.
This does happen with face lifts. You describe hypertrophic scars and not Keloid scars. You have done everything right. The scars are active which is why they are sore and tender. Re-excision is best. Steroids can be injected in one week or at the time. The most important thing is that the scars will now not be closed under tension.
At eight months after a facelift, the scar is still maturing.If it is a problem at a year, you may want a scar revision. WIth less tension it may heal better.
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Non ablative 1540 laser may be best treatment for facelift scars
Raised red scars after facelift are typically Hypertrophic Scars caused by the tension on the scar produced by the skin that has been tightened.
In my experience treatment of reddened rasised scars after facelift can be helped by treating the facelift scar with Non-ablative fractional 1540 Erbium Laser treatments. Usually 3 or 4 treatments are required to lessen the redness and reduce the bulk and size of the scar. I use the Lux1540 laser and have been happy with the results. The benefit of the laser is that unlike steroid injection, there is no risk of tissue atrophy or production of visible red blood vessels in the treated area.
Eventually after the scars have matured it may be necessary to surgically revise the scar-this can usually be done under local anesthesia and can be used as an opportunity for further tightening of the facial skin
I am somewhat surprised that Steroid injections and Silicone Sheeting did not help lessen your facelift scars. Have you asked your doctor if the scars are true Keloid Scars-if so excision of the keloid and post excision radiotherapy may be required
This is a tough problem. If there is some reason for the poor scarring - delayed healing, too much tension, wound infection, spitting stitches, etc - then a revision is very reasonable assuming the aforementioned issues could be avoided. But if everything went very well early post-op, you just may be one of those people who scars badly and revision may not help. Discuss this with your surgeon and it may even make some sense to get a second opinion. Also, easy does it on the steroid injections. They can cause atrophy of the fat and widening of the scar.
Lisa Lynn Sowder, M.D.
Scars Below Earlobes after Facelift
After exhausting all scar treatment modalities, surgical excision is your only option. The operation is significantly easier and recovery much quicker.
Scars and Facelift Surgery
It appears that you have had reasonable treatment for a scar. The silicone sheeting can be tricky on the face and often is a long-term treatment modality for scar management. Once non-surgical treatment modalities have been unsuccessful then surgical correction is warranted.
Scars after a facelift
Short of surgery, the only other thing you might consider is a custom made compression garment using the silicone sheeting beneath this. Although it would be ideal to wear the garment 24/7, you may try to at least wear it at home and during the night. Compression with silicone sheeting has helped more than either modality alone. Otherwise, scar revision when the tissues are more pliable may be the only other option.
Very tender in the lobe
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