I live in the Madison, WI area and am seriously considering a face lift. The main thing holding me back is how bad it looks behind the ears...even after months/years. I've had a few friends do it and they have "bunching" and prominent, white scaring behind their ears. I've also talked to a few in the industry and apparently this is common? It seems I must decide between sagging or wearing my hair down for the rest of my life?
Face Lift - Looks Awful Behind the Ears?
Doctor Answers 43
Following surgery, many surgeons, myself included will offer complimentary V-Beam laser treatments to help speed healing and minimize scarring. Most plastic surgeons also make topical silicone gel treatments available to help minimize scarring. Close monitoring following surgery is imperative. If scars start start to thicken, they can be treated with steroid injection. But early treatment is key. You don't want to wait until a scar is a problem before you begin receiving treatment
Research Surgeon Carefully to Avoid Bad Facelift Scars
While there is always a risk of scarring after ANY surgical procedure including Face Lift, seek a board certified facial plastic or plastic surgeon with experience, training, expertise, and credentials to provide the best surgery for you. I say to my patients "Good Facial Plastic Surgery doesn't look like surgery, it just looks good!" Face lift scars from a well performed surgery should be virtually invisible - white, flat and well placed behind the ear so that a patient can wear even close-cropped hair and all everyone will notice is their gorgeous rejuvenated face. Find a surgeon with before/after books you admire and previous patients you can consult with. Good luck with your surgery!
Proper incision placement and flap distribution prevents tell-tale scars.
It all comes down to having a good plan, good experience and good execution. If any one of these three factors go awry, a bunched scar can result. Often the attempt to make a facelift scar too short is the culprit. The effort to make the scar less apparent (shorter) backfires and it is more conspicuous (bunched). Tell your surgeon, you'd rather have a longer great scar that is concealed by hair than a shorter visible one.
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Minimizing facelift scars
Facelift scars can be minimally visible, or keloidal and obvious, or anything in between.
Experienced surgeons have better scars. There is a certain ability that comes after a surgeon has done 1000 facelifts that is simply not present in a doctor who has performed 100.
Skill level of the individual surgeon often goes hand in hand with experience, but not always.
The technique chosen also determines how scars will appear. Hairline techniques will always disturb the hairline and be more visible than scars behind the hairline. Short incision techniques may inherently bunch skin more. "High on the side" techniques will always create a rise in the lateral facial tissues that is not matched by a rise in the central facial tissues. Skin-only facelifts closed very tightly inherently will place large tension on the incision closures, resulting in worse scars.
Follow-up is very important. Are patients applying the creams or silicone sheeting the surgeon recommends, and avoiding sun exposure? Hopefully.
Some patients simply heal worse. Patients with darker skin types tend to form keloids more readily than light skinned patients.
If scars do thicken despite best efforts, is the surgeon willing or able to perform injections, laser treatments or revision of the scars? It is often necessary, even in the best of hands. The surgery is not over when it is over, it is over when the patient is healed.
Face Lift - Looks Awful Behind the Ears
The healing process in general can take up to one month for the majority of swelling to subside, incisions to close, sutures to come out, and for bruising to completely go away. #Recovery time from a #facelift varies from person to person, but patients can generally expect to be presentable within three weeks from surgery. Patients should expect swelling, bruising, and discoloration of the skin during this phase of recovery (swelling normally goes down after 48 hours; most bruising will go away within two weeks). When the skin is separated from the underlying tissues during surgery, small sensory #nerves are cut. Varying degrees of numbness will be present after surgery and will improve gradually as the nerves reconnect to the skin. This process can take from 2-6 months for face, neck and cheeks, and to 9-12 months for the forehead and scalp. Muscle weakness may also be present around the mouth especially if liposuction is used. This typically recovers fully in the months after surgery.
As the nerves regenerate, the itching, burning, tingling and shooting #sensations will occur. Ice, moisturizers and gentle #massaging are helpful during this phase of the #healing process. Frequently there is a tight feeling in the neck, jawline and cheek after a facelift. During surgery, not only the skin but the underlying muscles are tightened to create a better and longer lasting result. Additionally, the #swelling will move downward in the first week and the neck will feel even tighter. Do not be alarmed: the sensation will decrease during the first month.
Some degree of firmness or lumpiness under the skin is normal after surgery and will resolve with time. Local #massage of the areas may accelerate the resolution of this problem, which normally takes 2-4 months to disappear completely.
The marks from a facelift can easily hidden with “camouflage” make-up which you can learn how to apply. The scars from a facelift 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. 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. In most healthy people without a history of healing irregularities, the surgical scars resulting from a well-performed facelift are rarely an issue. Incisions are designed to result in scars that are concealed within natural curvatures around the ear and hairline. Most patients consider those scars to be acceptable with makeup within 1-2 weeks, although full scar maturation takes many months. Once mature, most scars are imperceptible in normal social interactions, although not entirely invisible upon closer scrutiny.
Lasting bunching is rarely encountered when the incision length is appropriately designed and performed. Some surgeons may attempt to minimize the length of the scar. This may be to shorten the procedure duration or as in response to patient request or perceived preference. When an appropriately long incision is utilized, bunching is minimized. Once patients are educated about this, most understand and approve of the trade-off between a longer incision but less bunching and an often superior result.
The appearance of white scars behind the ears may be minimized by extending the incision high behind the ear and into the post-auricular hairline. This may result in a longer scar, but a more easily camouflaged one. Again, once educated, most patients approve of this trade-off between a longer incision but less visible scar.
A well designed and performed facelift incision, which is appropriately cared for after surgery, generally results in a favorable scar which is rarely a source of patient concern.
Ultimately, the vast majority of patients consider the results of the facelift and appearance of facial rejuvenation to be a very acceptable trade-off for typically inconspicuous scars.
The most important thing when it comes to scarring after a facelift is surgeon technique.
Facelift - looks awful behind the ears?
If unsightly scars are still present after approximately a year's time, other things that your surgeon may consider are intralesional steroid injections, laser, or just surgical revision of the scar itself.
Hope that this helps! Best wishes!
Scarring depends on many things...
The surgeon can influence several of these variables, but unfortunately has no control over the patients wound healing biology. For these reasons plastic surgeons make every effort to place scars where they are well hidden when performing facelifts.
The facelift incision typically starts in the hair above the ear. Its then carried in front of the ear and then curved around the tragus and then extended downward to the ear lobe.It’s then carried onto the back of the ear and them posteriorly into the hair behind the ear.
Occasionally adverse scarring may occur in the area behind the ear following facelift surgery.In many cases this scarring is associated with bunching and gathering of the skin. This phenomenon typically occurs when a discrepancy exist between the lengths of the two opposing wound edges.This situation arises when surgeons make a conscious effort to keep the incisions behind the ear short.Under these circumstances scarring may result which may ultimately require a scar revision.
In the vast majority of facelift patients wounds heal nicely and scars are difficult to see. When wound healing is complicated the scars are often well hidden by incision placement. After surgery, scars are often extremely red and raised. With the passage of time these scars usually flatten and lose their redness.This improvement becomes noticeable in about six to eight weeks, but takes 12 to 18 months to reach completion.
Massage and topical agents can sometimes facilitate wound healing and are often recommended in the post-operative period.With these maneuvers most patients are happy with their results, but occasionally a rare patient will require a scar revision.
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.