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

I had a face lift in BELLEVUE Wa about 18 months ago. Bad experience wish I didn't do it. One side of my face had severe scaring which after going to another surgeon I found out was necrosis. On that same side I also have these stark white lines and small white marks. What could have caused this? They are not where I was cut. They appeared after about a month. I have to have a scar revision done but was told I have to wait a few years.

Doctor Answers 9


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,

Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 116 reviews

White lines in skin after Facelift

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.

Ernest Robinson, MD
Aliso Viejo Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

White marks after facelift

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. 

Steven M. Daines, MD
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Could be scarring

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

Keith Denkler, MD
Marin Plastic Surgeon
5.0 out of 5 stars 18 reviews

Scaring after a facelift

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

George Commons, MD
Palo Alto Plastic Surgeon
4.5 out of 5 stars 36 reviews

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

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, FACS
Denver Facial Plastic Surgeon

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews

Unsatisfactory face lift experience.

I am very sorry to hear about your experience
following the face lift operation. Without an exam
it is difficult to asses your concerns. Areas of
hypo-pigmentation may show after healing and
scar disturbances can be seen. Is possible you
may not have enough skin available for a revision
at this time. Discuss your concerns with a board
certified plastic surgeon you feel comfortable with.
See the link below for board certified plastic surgeons
in your area.
Best wishes.

Fernando Colon, MD
Columbus Plastic Surgeon
5.0 out of 5 stars 15 reviews

Facelift lines and spots

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.

Mark Been, MD
Barrington Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Post facelift scarring

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. 

Miguel Mascaro, MD
Delray Beach Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.