A recent consultation with plastic surgeon suggested a full face lift to correct rolling acne scars. Scarring is quite significant. After doing research on this however, a facelift is not typically recommended as opposed to laser resurfacing. I am 45 and feel that I look appropriate for my age so I'm wondering what the benefits would be to the facelift as opposed to laser and in what order are these procedures done?
Facelift to Correct Numerous Rolling Acne Scars?
Doctor Answers 49
Facelifts to treat acne scarring
I am going to agree with my colleagues that resurfacing is the treatment of choice for acne scarring. However, there is a limit to resurfacing. If you resurface too deeply, scarring, whiteness and prolonged healing occur.
So what is the next step?
Most acne patients over the age of 45 know when they pull their skin back it looks better. Sometimes a lot better. That is why for the very best result with rolling acne scars, resurfacing plus a facelift are indeed an excellent choice.
Acne scars can accelerate facial aging
The supporting layer of the face is the dermis. Acne scars represent weaknesses in this layer. I commonly will see patients who had extensive acne when they were younger and now feel that their scars are worse. Performing a facelift for many of these patients can be of benefit. The facelift can be followed by laser resurfacing or fillers to achieve even more softening of the scars.
Acne and Facelifts
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Facelift and acne scars
A facelift will not permanently improve acne scarring. It will definitely look better initially because of swelling, but I doubt any long term benefit.
Facelift for acne scarring.
Traditionally facelifts are considered for signs of aging and not for acne correction. Deep peels and CO2 lasers are usually considered primary treatments for acne scarring.
However, in my experience it depends on the specifics and degree of the acne scarring. If the scarring is more superficial in nature the laser or chemical peel is very helpful. However, for patients with deep "ice pick" type scars that appear to be attached to the underlying tissues no amount of laser will create significat improvement, especially if the scar is attached to the underlying tissues.
Dividing the scar at the base using a technique called subcision can improve the results. Additional improvements can be achieved by using filler agents or fat as a spacer after subcision. In patients who have one or two deep spots that may be adequate along with aggressive laser resurfacing. However, in patients who have multiple extensive deep acne scarring a facelift can also be helpful. It is important to remember that most of the time when we perform a facelift the elevation of the tissues happens at the deep level of the muscle. To release acne scars the lift should be primarily at the skin level. So the more correct procedure for severe deep acne scars is actually a subcutaneous type facelift rather than a traditional SMAS facelift.
Facelift Not a Good Help for Acne Scars
You are right: a facelift is not likely to help your acne scars.
Laser resurfacing (and dermabrasion) are better techniques for an incremental improvement.
Facelift to correct rolling acne scars
In many patients with acne scars this has caused pleating or folding of the skin, which can only be addressed with a facelift. In such cases, a facelift will provide substantial improvement in the overall appearance. Laser resurfacing may be a good choice if there is no significant looseness of the skin. Also, many patients benefit from having the facelift first, followed by laser resurfacing approximately three months later.
Laser Resurfacing versus Facelift
Facelift surgery is used to improve laxity in the skin and muscle of the face (particularly the lower face). Facelift does not directly address surface irregularities of the skin. Acne scarring is best treated with combination treatment such as excision of deep scarring followed by laser resurfacing at a later date.
Facelift and acne scars
A facelift will tighten the skin of the face, and may produce some improvement in the appearance of acne scars. Most often, however, some type of facial resurfacing with dermabrasion or laser is more effective, and may be combined with fillers for the more severe depressions.
Face Lift Not First Treatment for Facial Acne Scar
As other plastic surgeons have already stated, face lift surgery may not be the first option to improve the appearance of facial scarring. Face lift tightens skin and pulls on the sides of the face and neck primarily, while acne scarring is generally in the center of the face.
Acne scars are better treated by (1) resurfacing the skin, and (2) adding volume deep into the scar. Skin resurfacing may be performed with chemical peels, lasers, or dermabrasion. Volume enhancement may be performed with many injectable facial fillers or fat transfer. Generally, one needs to wait at minimum 6 weeks between face lift surgery and a resurfacing procedure. Only after a comprehensive evaluation can a plastic surgeon help determine an appropriate option for you.