is this normal scarring following a face lift/neck lift? (photos)

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Incision lines after face and neck lift surgery will take about 6-9 months to mature. You are in early stages of healing. It seems you're healing well. There are silicone gels and laser treatments that can improve incision lines less visible. 

Best Scar Management is important to minimize or completely hide from view, the telltale signs of your surgery—namely, scars. Both you and your surgeon want you to have the most minimal scarring possible. There are many possible causes for scars that are enlarged or not healing well. Unsightly scars are most commonly due to genetics, underlying medical conditions, or improper scar/wound care. The last part is very important and patients can make a noticeable difference in their scars’ appearance by following best scar management practices. Here are some simple tips.

Scar Management tips:Minimize tension on the scar. Steri-Strips and/or surgical tape are often placed in non-hair bearing areas at the time of surgery to minimize tension and keep pressure over the scar.  This minimizes the  stress that  can pull the scar apart (dehiscence) creating a wound and  delaying healing time, and can make the scar wider, or more “ropy”. In the first few weeks after surgery, I recommend the use of Embrace Scar Therapy which is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar.Keep your incision site/scar clean to prevent infection. Follow your surgeon’s wound care instructions to the letter with out modification. Never apply different products then recommended without first discussing them with your surgeon. This is especially important during the first few weeks. If there are any signs of infection, contact your surgeon’s office right away and/or see your doctor or his nurse immediately. Typical signs of infection may include redness outside the immediate incision site, asymmetric swelling, and drainage, of pus, fever, chills, and “feeling sick”.Protect your scars from the sun. Staying out of the sun is the best advice. Minimal exposure to sunlight is prevents hyperpigmentation (permanently turning brown) and other problems that can make the scar more noticeable. Sunscreen, at least 30 SPF and an overlying make camouflage make up additionally protects the scar from the suns harmful rays. This advice is especially important the first year following your surgery.Use specific scar maturation products recommended by your surgeon. Patients seem to have their own opinions on this touting everything from Pure Vit E, Coco butter, to Aloe Vera, etc but most have minimal benefit other than keeping the scar hydrated. Although hydration is important there are better, scientifically studied products with greater efficacy. Most of the scientific articles written about this subject indicate that topical silicone gel or silicone sheets work the best. The best product available in my opinion is the Embrace Scar Therapy System by Neodyne BioSciences, Inc. available in many surgeons’ offices. Essentially this is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar. For areas that are not applicable for this product (e.g. smaller areas or on the face), I prefer BioCorneum or Kelo-Cote products There are a lot of products to choose from, but silicone should be one of the key ingredients. Although Mederma, an onion extract derivative active ingredient rather than mainly silicone based may help, primarily silicone based products are better and many also contain other ingredients that may be synergistic (hydrocortisone or other steroid, Vitamin E, Sunscreen, etc).. If the reader has problems obtaining these they can call my office. Patient compliance is also critical – use often and according to directions or it will not work optimally. NEVER apply products without first discussing them with your surgeon.Monitor to make sure your scar is progressing optimally. Keep your scheduled follow-up appointments with your surgeon to verify that your scars are maturing as expected.  Occasionally if indicated you may need a topical steroid preparation or even a series of  injections (5-FU and/or Steroids) or laser treatments  to treat or  prevent scar hypertrophy or keloid formation (red raised scars), or other topical medicines to treat post inflammatory hyperpigmentation (brown scars) with prescription creams and possible laser treatments.

The #scars from a facelift or necklift mature within six to twelve months from the surgery date. It is during this time that the rejuvenating effects of the facelift will become apparent and the real result will be seen. We find that scar reducing product, BioCorneum , appears to be very effective. If you have certain concerns about the procedures and #healing process, it is recommended to call your board-certified surgeon or their medical staff and discuss those #concerns.

Thank you for your question, it is still very early days, your scars are healing and will take 3-6 months to mature, fading to skin colour.  You may want to massage on a regular basis, in the future if you wanted to use steroid injections to soften the scars or scar revision would be a possibility.  Be patient and give them time, please return to your surgeon for regular follow ups to assess your healing progress.  All The Best

Thank you for your pictures.  The incision behind the right ear is lower than desired.  With time the scar quality may improve.  Best wishes.

Hi and thank you for your question. Fortunately you are early in the process and the scars will continue to mature and improve for up to a year becoming less visible. You may desire some revision on the scar, but at this point, time is on your side and its best to be patient. Best wishes

The scars are asymmetric.  We usually try to keep the scars higher behind the ears so that they are less visible.  The good news is that you seem to be scarring well.  These scars may eventually be hard to see.  Some laser can also help with the healing.  It would be unusual for someone having a facelift to not benefit from some tightening of the neck at the same time.  

Thank you for your question. The most traditional facelift procedure uses an incision along the hairline around the temples and will continue around the ear. The necklift also utilizes an incision made at the earlobe wrapping around the ear to the base of the scalp. You may find improved scarring as you continue to heal. Please remain focused on the recovery instructions provided by your board certified facial plastic surgeon. During your next conversation, you should mention this scar and discuss the possibility of scar revisions in the future.

Best wishes,

Thank you for your question.  I am so sorry that you had complications after your face and necklift.  It sounds as if your surgeon is caring for your incisions with silicone gel/sheeting.  At 8 weeks post-operative, it is still possible to have some redness with the incisions, as you are noting in your photos.  I would continue to follow your surgeons instructions, and with time this redness should improve. Sometimes a small injection of steroid will help with this redness, as well.  Be sure to continue to communicate your concerns with your surgeon.  I hope that this helps!-David Gilpin