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Best Treatment for Scars After Face Lift

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.

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

Seattle Facial Plastic Surgeon
5.0 out of 5 stars 154 reviews

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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.

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 39 reviews

Scar treatment

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.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

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

Facelift scars

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.

Good luck.

Lisa Lynn Sowder, M.D.

Lisa L. Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 53 reviews

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.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 18 reviews

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.  

Dr. ES

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.

Theodore Katz, MD, FACS
Philadelphia Plastic Surgeon
5.0 out of 5 stars 7 reviews

Very tender in the lobe

Sometimes, unfortunately bad scars do happen.  Hypertrophic scars around the lower ear and lobule are where most commonly bad scars do occur in facelifts.  This is due to an attempt to excise more skin and obtain a better result.  However, more skin excision in the area of the lobule results in a pulled lobule and a hypertrophic scar.  You have tried silicone gels and steroid injections with minimal improvement.  At this point, i would recommend readvancing the skin flap on the affected side, removing and reclosing the scar under no tension.  Discuss this option with your plastic surgeon.

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.