What is the least scarring face lift? Can it all be hidden in the scalp?

There are some surgeons
offering lifting procedures with minimal access incisions, but the only thing
that can be done through those incisions is elevation of the deeper tissues via
sutures. Since tissues are not truly
repositioned but only dragged to a new position, they are totally dependent on
how long the stitches hold. Studies we performed at Northwestern University
indicated that one technique similar in concept gave very short-term results: only
a few months.

Even in patients with a
history of poor scarring and keloid formation, the scars at the visible portion
of the ear (in front) are at the edge of the ear and closed under no tension. They
are virtually never visible after 2 to 3 months, even in men or women who wear
their hair pulled back. The scars behind
the ear are easily hidden, but sometimes in patients who are prone to have pink
and highly visible scars, they do need to be revised. I would suggest you
consult with more than one experienced surgeon and ask to see patient examples
with early scars, as well as scars that have matured. I find that once patients
have seen a number of postoperative photos, they are comfortable with the
scars, which are hidden at the edge of the ear and not visible.

Thank you for your question.   There are many marketing ploys out there claiming to make short scars, invisible scars or even no scars at all for a face lift.   The reality is each surgeon has a different approach, however to perform a face lift you need to make an incision somewhere.   Don't do a face lift or choose your surgeon based on who will make the smallest scar as that may not be the right procedure for you.   Find a board certified plastic surgeon, go in for a consultation and ask to look at before and afters of their work to see the scars.   A face lift is a great operation with a high success rate and the scars typically heal quite well.   Make a good decision overall, not just based on the scars.   Good luck!

All surgical facelift techniques involve incisions, but how these incisions are designed, where they are placed, and then closed can be very different from surgeon to surgeon.  It is wrong to consider a facelift technique based on the length of the incision, where dubious marketing claims have made many prospective patients incorrectly think a shorter incision is better--results and studies have proven otherwise.  Proper facelift techniques require long enough incisions to allow proper re-positioning of the SMAS layer and removal of redundant skin in a smooth fashion.The attached link provides more information.I hope this helps.  

The least scarring facelift is the one done by an experienced and detailed surgeon. Although the full incisions in front and around the ear are necessary, these can be made to hide very well. You might be thinking of endoscopic or "thread lifts". Endoscopic lifts only address the brows. Thread lifts have a high incidence of string rupture and future asymmetry.

Any facelift that addresses the lower face and neck requires incisions around the ears.  However, well placed and well closed incisions should result in scarring that is very inconspicuous and minimally visible.  Viewing before and after photos and meeting other facelift patients of your chosen surgeon should give you a pretty good idea of what to expect.  Good luck!

Your specific concerns about your appearance should be discussed before you decide on incision size or placement.Although the advantages of a small and hidden incision may sound appealing, this may not be correct for you.If your aging changes involve your neck and jowl, these areas are less likely to be improved with a small hidden scalp incision.  An attempt to correct these distant areas may increase the risks of nerve injuries, and place too much tension on the small incision, creating an area of alopecia.  It may shift your hairline posteriorly.  Smaller incisions don't allow for the same amount of skin draping. Traditional, around the ears, incisions allow for more effective undermining, redraping and excision of skin excess.  It also has the ability to address the underlying tissues, such as the SMAS.  It is a more direct route to the jowl and neck.Traditional incisions are longer and therefore have a higher risks of scarring including ear distortion and hairline shifts.  If performed correctly they should be difficult to notice.Consult a Specialist in your area to determine your needs.  Consider your goals before you choose the incision type.  If your risks of scarring are too great ask your doctor about other options such as filler, Botox, Kybella, skin treatments used in combination.

Generally, smaller scars are associated with less
aggressive lifts. While this certainly can be done on any patient, it may not
be the best procedure for everyone. People with more significant jowls and
excess skin will require a more aggressive technique to obtain a satisfactory
result. During your consultation, it is important to show your plastic surgeon
scars that were present from other procedures. He will be able to determine
your potential for poorly healing scars and the technique that will give the
best results for your face.

Great question! The best place to place the scars are behind the ears in the retro auricular groove, and behind the tragus of the ear, since this will hide 100% of the scar. Some surgeons make it anterior to the tragus and this is a mistake because this scar will be very visible. A small portion if the incisions are made in the scalp and this is done in a way that it does not destroy the hair folicules, so it will not kill those hairs, and it will hide perfectly this portion of the scar. Also, the best way to avoid a keloid is to leave the skin without any tension and suture it in place. I do this by placing all the sutures in the fascia that envolves all the facial muscles, the SMAS; this way when I suture the insicions, the skin will be totally tension less, and this will avoid the production of hyperthrophic scars and keloids. With the SMAS Facelift you can rejuvenate your face from 15 to 20 years in my experience. Have a good day

  With a incisions for a facelift are placed inconspicuous  underneath the temporal tuft hairline, behind the tragus, and into the hairline and behind the ear. Placement of the incisions is critical for detectability. In addition, the amount of tension placed on the skin and the length of time the sutures are left in place also increased detectability. In addition,  the amount of loose skin will determine how long the incisions are. A well executed face and neck lift incisions will be minimally detectable. Look for a surgeon who can create natural results.

Hello Rafchoochie,The only type of lift that has all of the incisions within the hairline include the brow lift and the endoscopic mid face lift.  This means it would not adequately address the jowls or the neck.  One of the biggest limitations with the endoscopic lift is the tendency to change the shape of the outside of the eye and make the eye appear more slanted.  In order to adequately address the cheek/jowls the incision needs to be next to the ear (there are a few different ways to make this incision and the hide really well).  In order to address the neck the incision needs to extend behind the ear and either along or within the hairline.  It is important to distinguish hypertrophic scars (scars that get big but stay within your original incisions or cuts) from keloid scars (grow beyond the original incisions).  The reason is that hypertrophic scars can be readily treated and minimized with proper techniques, but keloid scars can form even with the best closures and are difficult to treat.I'd recommend you consult with a facial plastic surgeon or plastic surgeon to learn about your options and determine if you are a candidate for surgery.I hope this helps and good luck.