I am 9 day post MACS facelift, upper eyelids and fat transfer to face. Will the bunched up skin improve? (Photo)

Question

The scaring behind my ears have horrified me. The skin is all bunched up and my right ear is now higher and sits out more than originally. I have seen much smoother jobs online. I also cannot talk properly because of the tightening of the neck which also has left dimple affects both sides of neck. Will this bunching flatten completely? If I need surgery to fix this when would it be suitable to undergo? Have I expected too much this early?

John Michael Thomassen, MD · Answer

Your skin has gathered up behind your ears more than usual.  However it definitely will improve with time.  Your surgeon may need to revise this to obtain the best contour and scars.

Ben Lee, MD · Answer

Contour irregularities after facelift surgery can be seen regardless of technique. Fortunately, it  is an often forgiving surgery and minor contour irregularities and bunching usually improve with time. This often results from an attempt to limit incisions, which is a noble goal. Nevertheless, some degree of bunching can be seen in short scar facelifts because the skin is not allowed to optimally redrape. In this case, the bunching will improve, but I would be prepared for some minor skin revision.

Larry S. Nichter, MD, MS, FACS · Answer

You are still very early after surgery and way too early to determine your final results. If you have reasonable elasticity most if not all of your observed concerns will resolve on their own. With swelling, edema, the ear lobe will stand out, but this too will resolve.

Jed H. Horowitz, MD, FACS · Answer

You are still very early in your postoperative recovery and I would recommend that you give yourself more time before you judge results. That being said, it does appear that you already have a significant amount of excess skin still present and may need a revision.

Martin Jugenburg, MD · Answer

It's too early, your face will go through a lot of changes.  I don't think 9 days after surgery is enough for you to see the final results.  YOu may or may not need a touch up, but I would allow things to heal for at least three months before jumping into a revision.

Damien Grinsell MBBS, FRACS (Plast) · Answer

Hi. It is still early days. The trade iff for a shorter scar facelift is some bunching and you will be amazed at how well it settles down. You will be thankful for the tight neck with time and it will soften. Regards

Vincent N. Zubowicz, MD · Answer

Swelling will exacerbate the appearance of the skin being gathered up but I think this is going to be a permanent problem for you without a surgical revision.

Bhupesh Vasisht, MD · Answer

This could be a problem or not but too early to tell.  Bunching of the skin can happen from the short scar that tends to happen less from the regular scar facelift..it is an issue of geometry in my opinion.  I would wait and see how this plays out but remember that some folding of the skin can have a natural appearance once all the healing is complete.Good luckDr VasishtSouth Shore Plastic Surgery Voorhees, NJ

Guy Watts, MBBS (Hons), FRACS (Plast) · Answer

Thank you for your question and images. 9 days is very early in the healing process and therefore you need to be patient to see the final results. Your incisions are not consistent with a true MACS lift where the incision finishes at the bottom of the ear lobe. Therefore your surgeon likely extended the incision behind the ear to allow for excess skin however this also needed to be extended to the hairline. The true art of facelift surgery is to choose the correct vector for the SMAS suspension and then tailor the overlying skin to avoid excessive bunching. At present the best thing to do is to be patient, the bunching will certainly improve with time. If you are not happy with the final results I would be more than happy to review your case.RegardsDr Guy Watts

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thank you for your pictures.  The gathering of skin behind the ears is typical for a MACS face lift.  The slight gathering in front of your ears is not ideal.  I would re-evaluate your result at three months.

I am 9 day post MACS facelift, upper eyelids and fat transfer to face. Will the bunched up skin improve? (Photo)

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