Facelift - stark white lines and spots close to the surgery area?

Thank you for your question. You may be experiencing necrosis, an uncommon complication where skin tissue begins to die and fall away from the incision sites. This happens when there isn't sufficient blood supply tends to be more prevalent in smokers. Remain patient through your healing and address a revision facelift surgery after 12 months. Always consult with a board certified facial plastic surgeon.Best wishes,

I am very sorry to hear about your experiencefollowing the face lift operation. Without an examit is difficult to asses your concerns. Areas ofhypo-pigmentation may show after healing andscar disturbances can be seen. Is possible youmay not have enough skin available for a revisionat this time. Discuss your concerns with a boardcertified plastic surgeon you feel comfortable with.See the link below for board certified plastic surgeonsin your area.Best wishes.

Thanks for your post. If you would be willing to post your photos, I may be able to better comment on the nature of your concerns. In general, if there is vascular compromise to the skin flaps in the healing process following surgery, there can be discolorations that appear in the skin. Typically these are transient in nature, but may require conservative therapies to improve. However, If damage to the pigment producing cells occurred and these white spots represent areas of scarring or hypopigmentation, then the damage may be permanent and require surgical revision vs. camouflage techniques. I'm sorry you had a negative experience with your surgery but there may be ways to optimize your face over time. Be sure to work with an experienced facelift surgeon as you attempt to resolve these problems.

I'm sorry to hear about your experience.  Without any pictures, it is hard to assess what may have happened.  But based on what you are describing, area of previous necrosis on the same side leading to scarring, the stark white lines are most likely extensions of the scarring from the poor blood supply that led to the necrosis.  They occur because the dermal blood supply stops, and once this happens the cells that bring color to your skin stop working. This does not have to happen where there is an incision - just where there is a lack of blood supply (and there are a number of reasons why this can happen).  There are different ways to try and get the pigment back to the skin, but unfortunately none of them are 100% effective.  It's best to see a PS in your area for consultation and figure out what can and cant be done.  Best of luck. 

A facelift includes underming, the lifting of skin in the subcutaneous plane.  This is accomplished most of the times with scissors.  As one advances, undermines, the skin the blades of the scissors may come too close to the skin, essentially de-fating the subcutaneous skin and rubbing into the dermis, creating white lines in the areas.  When dissecting the skin one should undermine the skin in a level plane.Waiting a few years is an excellent idea.  Try IPL or other treatments that may improve you skin and dermis.

When the skin is closed under excessive tension during a facelift, unfavorable scarring can occur. Other factors that can contribute to unsightly scars include infection, poor suture technique, smoking, hematoma, and a genetic predisposition for forming thick scars. In addition to surgical scar revision, lasers are often another option for patients looking to improve their scars. Please consult with a qualified, reputable surgeon in your area to discuss your options. 

The white areas could be areas of hypopigmentation from stressed circulation.The necrosis is a sign that there were some areas of compromise.

It is possible to develop skin necrosis or scarring outside of the incision lines, though both are very rare. It sounds like you will need to undergo a revision facelift. Typically, waiting 12 months is perfectly adequate time to have this addressed. In the meantime, fractional laser resurfacing can be helpful to reduce the prominence of excessive scarring. Best.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Sounds like you had some areas that struggled to heal because of marginal circulation.   This happens rarely and is a known complication of facelift surgery.  At one year you can have these revised nicely.   My Best,   Dr Commons