{"id":19460,"date":"2021-04-26T11:53:32","date_gmt":"2021-04-26T18:53:32","guid":{"rendered":"https://www.realself.com\/news\/?p=19460"},"modified":"2023-08-25T11:15:36","modified_gmt":"2023-08-25T18:15:36","slug":"plastic-surgery-fails","status":"publish","type":"post","link":"https://www.realself.com\/news\/plastic-surgery-fails","title":{"rendered":"Plastic Surgery Fails: Telltale Signs of Facelifts, Eyelid Lifts, and Nose Jobs"},"content":{"rendered":"

We’ve written, a number of times, on the hallmarks of coveted surgical outcomes, with the goal of spotlighting key elements to look for when you’re studying doctors’ before and after photos—be it a supernatural belly button on a tummy tuck<\/a> or that just-right nipple position with a breast lift<\/a>. Whenever we report one of these stories, the surgeons we interview will inevitably flip the script, to approach the topic from a juicier POV—the little things that make them cringe when they see other surgeons’ work on social media or IRL. <\/p>

While you might assume that the critical eye of a plastic surgeon can detect subtle blips that the average onlooker would likely miss, that’s not always the case—which is precisely why there exist classic tells, or giveaways, of popular procedures. “Even though they’re generally small features—a couple millimeters, here or there—they catch your eye passively,” explains Dr. Laxmeesh Mike Nayak<\/a>, a board-certified facial plastic surgeon in Frontenac, Missouri. “You don’t have to look for them,” he adds, and even if you can’t articulate exactly what’s wrong with what you’re seeing, “you don’t have to be a surgeon to know something’s not right.” <\/p>

Moreover, what makes these pieces of evidence so damning is their inherent gravity: “Even with an otherwise great result, they can mean the difference between a happy and unhappy patient, [because] they make people really self-conscious,” notes Dr. Nayak. That said, not every tell is indicative of subpar surgical skills, he points out—sometimes human tissue just behaves unpredictably. But since fixing these issues often requires a second surgery—one made more challenging by now altered anatomy and scar tissue from round one, says Dr. Tanya Khan<\/a>, a board-certified oculoplastic surgeon in Austin, Texas—you really want to get it right the first time. <\/p>

Ahead, the most obvious signs of nose jobs<\/a>, eyelid surgery<\/a>, and facelifts<\/a>—2020’s top surgical procedures, according to the American Society of Plastic Surgeons <\/a>annual trends report<\/a>—and how surgeons aim to avoid them.<\/p>

Facelift fails<\/h2>

“You only see the bad work” is a common refrain among plastic surgeons—and applies perfectly to facelifts. The powerful procedure tackles loose skin and droopy jowls, restoring youthful contours, for a naturally refreshed look—but it’s no small surgery, and hiccups can happen.   <\/p>

Poorly placed incisions<\/h3>

For virtually every surgical procedure, conspicuous scars are an obvious tell. With facelifts, concealment involves an added degree of difficulty, because scars—especially long, winding ones—can’t easily blend in on the face. <\/p>

Traditional facelift incisions generally start in the hairline, at the temple, and travel around the ear before terminating in the lower scalp. “All incision lines heal into a white or fair line, so we try to nestle them in highlights and shadows,” Dr. Nayak explains. “The ear has all kinds of reflections on it from its sharp bends and contours, and if we place our incisions in the right spot, that fair section passes as a reflection.” If cuts are not strategically positioned—or if scars drift forward months to years later, as can happen with a too-tight facelift—even the finest, flattest line will read as a glaring sign of surgery.<\/p>

Interested in facelift?<\/small><\/div>Find Doctors Near You<\/a><\/div>

Missing sideburns<\/h3>

Sometimes attempting to keep incisions off the face can disturb the hairline. When slicing into the temple area, if the sideburns<\/a>—which, even in women, are an important landmark—get lifted along with the face and trimmed away, says Dr. Nayak, “you could end up with a big hairless patch of cheek in front of the top of your ear, which makes your hair almost look like a Lego cap, set on top of your head as opposed to being part of the frame of the face.”<\/p>

Misshapen ears<\/h3>

Once a surgeon elevates and repositions the deeper tissues of the face and addresses any excess, they should close with the skin in utter repose. “Facial skin is not built to hold tension,” Dr. Nayak tells us. “It can be tempting to get a little more effect by pulling on the skin when you close, but it’ll inevitably stretch and relax back out.”<\/p>

And when an overly taut facelift gradually gives way, not only can scars widen and drift, but the ears can get contorted. “If there’s too much tension on the wound or too much skin resected [cut away] around that area, the scar can contract over time, pulling the tragus forward,” says Dr. Catherine Chang, a board-certified plastic surgeon in Beverly Hills, California. The tragus is a tab of cartilage in front of the ear that helps to obscure the ear canal. When the tragus shifts, adds Dr. Nayak, it exposes that hole in the head while also losing certain identifying characteristics. “There should be a little bright convexity on the tragus itself and a dark concavity just in front of it,” he says. “Without that hill-and-valley feature, it looks a bit odd.” <\/p>

Tension is also to blame for the so-called pixie ear deformity<\/a> that can occur following facelifts. And unfortunately, the cute name belies its appearance: “The earlobe is pulled downward and looks tethered and stretched,” Dr. Chang explains.<\/p>

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A post shared by Michael M. Kim, MD (@drmichaelkim)<\/a><\/p><\/div><\/blockquote>