True Face Lift Incisions?

I had a facelift in Costa Rica 19 months ago. The results were gone within 3 months, and I had no incisions in the temple area! Now, if I pull up from above my ears, I can see the result I was expecting. Should a true facelift have incisions going into the hairline by the temple?

This has been the biggest mistake of my life, to travel half-way across the world to a doctor who appeared to be at the top of plastic surgery. I wish I had gone to the USA or stayed in England.

Doctor Answers 14

Incisions for a facelift serve 2 main purposes: access...

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Incisions for a facelift serve 2 main purposes: access to the deeper tissues and removal of excess skin. Facelift incisions are something that many people are concerned about before the procedure but, if planned thoughtfully and executed with expertise and care, they should be virtually invisible. The key to the outcome after a facelift is less the incision but more so what has been done underneath the skin. Some repositioning of the SMAS layer is necessary in order to achieve long-lasting improvements. Personally, I prefer the deep-plane approach where the cheek fat and the SMAS are repositioned for the most natural appearance. Having said that, an extension of the incisions into the temple region is commonly necessary for appropriate lifting.

We see quite a few patients who had there surgery abroad, most of them with problems but some of them with a good outcome. And then there may be many patients that are pleased with their out-of-the-country surgery and other who are too embarrased to look for help.

In general, it is important to choose your cosmetic surgeon wisely and do your research beforehand. If you are interested in facial rejuvenation, look for somebody who specializes in these kind of procedures. A plastic surgeon who did a great job with your friends tummy tuck may not be a very experienced facelift surgeon.

Worcester Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews

A second procedure would likely provide the rejuvenation you desire

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There is indeed a “standard” for characteristic incisions for facelift surgery. However there are variable placements amongst surgeons. More often than not, temple incisions are performed by the majority of facelift surgeons. This is either in the hairline area running horizontally from the ear or running vertically above the ear in the hairline. Now there are some physicians that can get a good result without making incisions in the temporal hairline area, but this is dependent upon the specific individual’s skin laxity issues. Probably the majority of individuals do require an incision in the temporal area. Importantly I have seen good results achieved without an incision in the temple area. Understand that there are a small percentage of facelift procedures that do not achieve the desired result. Albeit that this is a level less than 1% of instances. Nonetheless it does occur. The good news is that likely a second procedure would provide the rejuvenation that you desire.

David Q. Santos, MD
Bellevue Facial Plastic Surgeon
4.3 out of 5 stars 23 reviews

Incisions from facelift

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There are various incision desgins for facelifts, and not all make temple incisions. Some use hariline or side burn incisions.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Short cut facelifts give short cut results.

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A thorough facelift almost always give good results.  There is a period of convalescence but once this is behiind the patient, most never need another in the future.

Invisible But Effective Facelift Incisions

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Facelift incisions serve the purpose to allow access to the parts of the face being operated upon.
You describe disappointment rapidly after your procedure, which generally results  from the removal of only a small amount of skin with little or no alteration of the deeper, supporting structures of the face.  Since the skin has very unpredictable elasticity, any initial benefits from the surgery are very subtle and short lived.  Very effective facelifts can be performed with no incisions extending into the temporal hairline. If only addressing the lower two-thirds of the face, as in the cheeks and neck, superior incisions can be limited to the anterior sideburn.  The pull you describe sounds as if you desire the tail of your lateral eyebrow to be elevated, which is very youthful and attractive, and can be performed without visible incisions in the temporal scalp either directly or with endoscopic assistance.
In all cases, facelift incisions placed meticulously and without tension upon closure should be generally not visible.

Facelift Incisions

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Facelift incisions help surgeons get access to the structures to lift, as well as allow surgeons a method of removing the excess skin.  

The economics of plastic surgery is quite different than purchasing a television.  Essentially a specific model and brand of television will be the same regardless of where you purchase it.  On the other hand, there is a wide difference between a superior result, well-concealed incisions versus  wide, poorly healed scars with little to no improvement in facial aging.  Chose a surgeon based on results.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 181 reviews


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Facelift involves a well concealed incision that starts either in the hairline or just barely in front of it and travels down and around creases in the ear and either into the hairline in the back of the neck. Lifting and tightening the skin and muscle beneath give the right direction of tightening for a pleasing result.  

Often in the U.S. patients go outside of the country for "inexpensive" plastic surgery (MEDICAL TOURISM)  but there is no real way determine of a surgeon has the appropriate training.  In the U. S. board certification helps patient separate surgeons with appropriate training from those that do not.

Dr. ES

Fcelift incisions

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I see a lot of people travel to similar countries and even third world countries to have plastic surgery at a very cheap price.  You get what you pay for and sometimes worse.  You are lucky there are no major deformities or problems like I have seen commonly.  You certainly sound like you would benefit from a real Facelift.

Jason B. Diamond, MD, FACS
Beverly Hills Facial Plastic Surgeon
3.9 out of 5 stars 13 reviews

Facelift incisions are variable

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Facelift incisions are variable. In some cases, incisions in the temples are used while in others, the incision will stop at the edge of the hairline. There is no right or wrong answer. I'm sorry to hear that you did not get the results you want. I would suggest visiting a plastic surgeon who will listen to your concerns and provide possible solutions.

D.J. Verret, MD
Dallas Facial Plastic Surgeon

Facelift Incisions

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I'm sorry to read about your disappointing experience. I rarely use an incision in the temple area; this is not the cause of your poor or non-existent results. It is best for a patient to have their cosmetic surgery in a country where standards and regulations protect the patient. Unfortunately, my only advice is go to an experienced surggeon for your revision.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 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.