Mini mac facelift - could the laser caused trauma to the incision area causing prolonged redness? (Photo)

Question

mini mac facelift 8 months ago .lots of complications such as hypertrophic scarring , pixie ears , continued redness . Though , kenalog injections have helped but havent cleared up everything as of yet . My question is , my surgeon boost about using a laser to make the incisions , is this a normal practice for this procedure to use a laser for the incisions ? Im asking , as if it isn't the norm , then maybe the laser has caused trauma to the incision area , causing prolong redness. Ideas ?

Jacob Tower, MD · Answer

Hello, hope you are well. Thanks for sharing your photo, background, and questions. It's not really "normal practice" to use a laser to make skin incisions for a facelift. There's nothing inherently wrong with that approach, but the vast majority of facelift surgeons use cold steel (a scalpel). As with anything, a cutting laser that is not used properly can cause collateral thermal injury to otherwise healthy skin and exacerbate scarring. It's more likely that you have hypertrophic scarring from excessive tension on the wound closure--relatively common with "mini facelifts". You can continue with scar modulation to hopefully improve the appearance, or consider a revision facelift to correct the scarring and pixie ear deformity.

Best,
Dr. Tower

Best,
Dr. Tower

Andrew Miller, MD · Answer

Scarring is most commonly seen with technique issues such as pulling the skin too tight. Some people are not great healers, but I would expect a better result than what you have. Whether the laser had anything to do with it or not, you need a revision full deep plane lower face and neck lift to free up enough tissue to excise your current scars and place new ones that are hidden and without tension so that can heal nicer. Be sure to see facial specialist for this.

Darryl J. Blinski, MD · Answer

Based on your one posted photo, and without seeing other incisions, if any on your body to compare most likely until a imp person or virtual consultation, the use of a laser to make skin incisions could be the issue here. Again, best virtual Consult with. Fee for revision pics or complete face of scar revision without laser is $8000-$15,000

Mats Hagstrom, MD (license on probation) · Answer

I’m going to come out and just say it.
Your facelift incision looks horrible.
On the bright side, it can be restored to look the way it should.
Are you sure you provider is a board certified plastic surgeon.
You should consider your skill in selecting providers. 
How and why did you select this provider? 
How many before and after pictures did you look at before you scheduled surgery from this provider?
It’s not how bad the scar looks as much as the design of the scar.
It’s terrible.
Look for senior board-certified plastic surgeons for focus exclusively facelift surgery in your community.
If you can’t find someone who only does facelift surgery, look for someone who primarily does this kind of work.
Plastic surgeons who approach mastery facelift surgeons tend to be in their 50s or 60s.
It’s not always the case, but usually facelift surgery is done on clientele who are a bit older and they usually select providers and their own age group.
To find the right provider, I suggest patients start the process by first making a list of board certified plastic surgeons in your area who seem to have an excellent reputation for the procedure you’re interested in.
Next schedule in person consultations with each of those providers, 
Do not rely on virtual consultations.
 if you consultation is not with the surgeon who is going to do your procedure then you’re in the wrong place. 
There’s no correct number of consultations needed to find the right provider.
The more consultations you scheduled the more likely you are to find the better provider for your needs.
The biggest mistake I see patients make is having only one consultation and then scheduling surgery.
having only one consultation, more or less eliminates the ability to choose a better provider.
In your case, you need a revision or secondary facelift.
The best plastic surgeons for doing revision work are usually the same plastic surgeons who do the best primary procedures. 
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who have similar facial characteristics to your own period
In your case, surgeons may not have that many pictures of revision work of similar characteristics.
Regardless, if you find a talented facelift surgeon, they should be able to help you.
 Laser is not the standard of care, but is used by some people(not many)
It offers no advantages in my opinion and it seems to be more of a sales gimmick than anything else.
I only know one plastic surgeon who uses a laser for skin incisions.
 His skin incisions are jagged, irregular, and the surgeon is not very talented in my opinion.
He’s not someone I would ever recommend.
Take careful notes during each consultation, especially regarding the quality and quantity of before and after pictures.
When in doubt slow down and scheduled more consultations.
4 to 6 consultations is probably an appropriate number before considering selecting a provider for permanent irreversible surgical procedure.
I’m sorry this happened to you.
I hope you find the care you need.
Ask your provider to forward a complete set of proper before and after pictures and copies of your operative report. they are part of your medical record that you can request at any time from your current providers office.
They’re not allowed to not forward your medical records.
Bring those with you for any second opinion consultation.
Good luck,
Mats Hagstrom MD

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