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.
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.
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.
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Acne and Facelifts
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.
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.
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.
Facelift offers minor improvement
A facelift may improve the appearance of acne scarring. However, it will not correct it. Facelifts tighten the skin and deep tissue layers. Dermabrasion is the technique which improves acne scarring most.
Facelift May Help Acne Scarring
After looking at your photograph, I don't believe a facelift is the answer to your acne scarring. There are patients whose acne scarring does improve with a facelift but it is only those people with scarring that destroyed sub-cutaneous fat and also have significant tissue laxity.
Sadly, acne scarring has no silver bullet. I am a very ardent proponent of prevention. Too many doctors trivialize their acne patients concerns. Acne scarring is a serious problem for the self-esteem of both men and women. With drugs like Accutane, it is only the rare patient that fails treatment. The risks of Accutane are real, but are absolutely manageable. I don't treat acne myself, but would much rather lose the business of treating acne scars than see anyone needlessly suffer.
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.