Any Way to Improve Scarring Caused by a Lifestyle Lift?

I know many of you have probably seen my post already but my mom got a LSL because the doctor told her her neck would be tighter, then during the operation she heard him say oops because he cut too much.

Anyways, it's been about 2 years since, and my mom's scarring on the front and back of her ears isn't getting any better. Can anyone share anything they've done to get rid of the scars? This would be so helpful.

Doctor Answers 7

Depends on the location and nature of the scars

The posts below were excellent. Just a few additional comments.

If your mother's scarring is due to bad scarring but the incisions were placed properly under the right amount of tension, conservative treatment with steroid injections, silicone gels or sheeting and tincture of time may help.

If the poor scarring is a result of excessive tension or distortion of ear architecture, pulling forward of the earlobe or tragus (bump in front of the ear), or mismatch of the hairline, these problems will not go away, and the best treatment is to perform a revisional facelift, using the extra tissue created by undermining to reconstruct the ear and hair elements above.

Good luck!

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 177 reviews

Revision Surgery is Best but not only Option

Hello Stephy,

Very good advice given here so far.

I would also like to add some additional advice. It would be very helpful to exam your mother to determine what the best treatment would be. Here are some options:

1. Kenalog/Steroid Injections: if the scars are raised or "ropey" appearing these injections can help reduce their size and discomfort. Time may be a factor since her scars are already two years old.

2.IPL Laser : this form of laser can be very effective in reducing the redness of the scars and can be combined with other lasers to soften and contour the scars.

3.Botox Injections: have been used with noted success in reducing pain and discomfort in postsurgical scars. There have been clinical reports of scar size being reduced as well. I will also use Botox during some scar revisions to help reduce tension on the scar as it heals.

4.Silicone Gel Sheeting/Tape: special tape designed to help reduce appearance of scars. Most often used with keloids and early scars but some benefit may be gained in older scar.

5.Scar Revision: if your Mother's main concern is to improve the scars then a scar revision would be very helpful. At two years out she may have enough skin laxity near the scars to allow enough flap elevation to remove the scars entirely and allow a tension free closure (important for preventing any additional scars). This would not necessarily address her neck or jowls but it would improve the scars.

6.Facelift Revision: if your mother is not happy with the results of her facelift and the scars, she should have a revision facelift where her jowls and neck will be addressed along with the scarring. This would require more skin laxity than just a scar revision.

An exam would also help because if her concerns are mainly with her neck, than a Necklift and not a Facelift would better serve her.

Hope all this helps and that your Mother gets well taken care of.

Kamran Jafri, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

I am sorry to hear about your mother's situation. This...

I am sorry to hear about your mother's situation. This is happening far too frequently.
The problem is two fold and you have identified one. Not only was too much skin taken but no deep structural support was provided to prevent the scar from widening. Skin can not be used as a support structure it is a veneer. Wide scars will always form when there is tension on the skin.
There is hope for resolution here depending on where the skin was removed and in what direction it was pulled. This is easily determined by an office visit or review of photos in the appropriate views. Often with these techniques there is excess skin remaining in the neck which can be redraped with minimal tension and marked improvement in the appearance of the scars.
I would encourage you to visit a Board Certified Plastic surgeon as there are many good ones in your immediate area.

Robert W. Kessler, MD, FACS
Corona Del Mar Plastic Surgeon
5.0 out of 5 stars 129 reviews

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I agree with Dr. Rand that this is a very difficult...

I agree with Dr. Rand that this is a very difficult problem and will likely require a revision procedure to address the issue. I would highly recommend to your mother to seek out a Board- Certified Plastic Surgeon to handle her care, and there are multiple outstanding surgeons in the Dallas-Fort Worth area.

It certainly would not hurt to have them see her now just to get a better sense as to what her options are, but the key here is that her problem cannot be handled by just anyone calling themselves a "Cosmetic Surgeon"-- please check out their credentials, training, board certification status and experience before considering another procedure.

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
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When too much skin is removed and needs to be pulled...

When too much skin is removed and needs to be pulled tight to close the incisions, the scars will be thicker and worse. Possibly, they can be injected with steroids or treated with IPL to soften them but the only way to revise them surgically is to wait a few years until there is enough laxity in the skin to have a properly done real facelift by a better doctor and remove the scars and close them under less tension.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Lifestyle Lift Scar revision

There are several factors that can cause scarring in a facelift. One of the most common and most avoidable is removing too much skin and the closing the skin under too much tension. This tension can create very wide scars and, if around the ear lobe can create a "pixie" ear appearance. Other factors include post-operative infection, post-operative hematoma, smoking, and genetics. 

Scar improvement options include steroid injection, laser resurfacing, and revision surgery. I have done a couple of scar revision cases for LSL patients who had hypertrophic scars. Ultimately, I had to do a revision of the scars surgically redraping the skin under no tension. The results were good but it is a major inconvenience to have to undergo a second surgical procedure. Make sure to consult with a qualified, experienced facial plastic surgeon in order to get the best guidance.

Todd C. Miller, MD
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 34 reviews

If the scars are now 2 years old, perhaps she can have...

If the scars are now 2 years old, perhaps she can have them revised. Poor scarring can be the result of many things including genetics, infection, too much tension on the wound closure, technical issues like poorly placed sutures, etc.. She should probably go to a board certified plastic surgeon.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 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.