Downward pulling feeling around the ear after MACS face lift, and a fold under the earlobe running down the neck. (Photo)

Question

6months after my macs face lift I was unhappy with the result, I didn't feel it was tight enough and where I wanted to be as pre discussed with my PS. He agreed to redo the macs lift but I was left with a fold, I later had a small correction under local to try and correct the fold. This all seemed fine but now the scar has rolled out of the tragus and I have another fold with a pulling sensation. I am concerned as what can be done as it looks and feel wrong.

Jed H. Horowitz, MD, FACS · Answer

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). Some degree of firmness or #lumpiness under the skin is normal after surgery and will resolve with time. Local #massage will speed resolution of this problem, which normally takes 2-4 months to disappear completelyNumbness or muscle weakness following a #facelift is not uncommon.  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. 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.

David W. Rodwell III, MD · Answer

For those patients reading this, one thing to understand about a MACS lift is that it involves a significant amount of lifting in the vertical direction.  This can be a good thing, but it may be contributing some to the problems that we see in the photos.  I think having a more thorough revision procedure will be your best option, but you should wait to see what changes take place over the next few weeks as the skin tension settles more.  Some of the problems in the photos seem to be related to the skin redraping and incision placement. You have had a recent MACS lift and small revision.  With that in mind I would suggest to wait for several more months before having any additional revision.It is difficult to guess at exactly what you might need if considering a revision, but if proceeding with that the skin needs to be undermined and properly redraped.  It is difficult to tell from these photos whether or not you need much done with resuspending the deep SMAS layers.The incision could be improved some.  Don't be afraid of considering bringing the incision pre-tragal or very carefully revising the post-tragal incision that you have.  The current incision placement is blunting the natural curves and creases around the ear, which contributes to an unnatural appearance that even the casual observer can pick up on as having that "operated" look.  Also, I would suggest continuing the incision behind the ear to properly redrape the area of bunching and banding that you see below the earlobe.Good luck.

Dean P. Kane, MD, FACS · Answer

Dear beaulady:Thanks for sharing your photos. Surgical lifts would be likened to pulling the bedspread
and / or top-sheet of your bed up to the head-board and removing the excess
material.If your bedspread is too lax for the incision,
darting and pleating are necessary to distribute the skin excess. Within the
incision, larger darts are removed in triangles leaving a line-scar. At the
ends of the incision, the extra skin pouch is often called a "dog
ear" and the incision will need to be lengthen in order to get rid of it. .
This seems to be what I see in your photos

The recent resurgence of the S-Lift (created in the early
1900's), also called by other names as the 
Quick-Lift, Lifestyle-Lift, Swift-Lift, Soft-Lift, MACS-Lift and others;
are a single modification of the S-lift targeted to elevate sagging lower
cheeks jowls and lateral upper neck. The shorter scar, limited undermining and
second layer lift may achieve the "quicker" procedure and therefore less cost but not necessarily the improvement you desire.

In decades past, the skin was pulled taught with less lift on the underlying soft tissues. Current best techniques will use the SMAS or fascial layer under the skin to lift and re-suspend the sagging soft tissues of the fat and muscle system underneath. The widely undermined skin will be redraped over the tighter, lifted quilting underneath to provide a soft and natural appearance without the pulled, wind-swept look of yesteryear.  You will need a longer incision, typically placed in the crease behind your ear with a new lift of the skin to achieve your goals. Ask your surgeon if this is within his / her skill level or consider a second opinion consultation with a well experienced, Board Certified Plastic Surgeon or ENT Facial Surgeon to revise your facial skin excess. I hope this was helpful. All the best!

Downward pulling feeling around the ear after MACS face lift, and a fold under the earlobe running down the neck. (Photo)

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Everything you need to know about MACS Facelift

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Downward pulling feeling around the ear after MACS face lift, and a fold under the earlobe running down the neck. (Photo)

Answers (3)

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Everything you need to know about MACS Facelift

Our mission is to create a world where every investment in modern beauty is Worth It.