What Kind of Facelift Leaves the Smallest Scar with the Best Possible Results?

I want to have a facelift to address slight jowls and perhaps double chin but I hate scars. It seems that most facelifts will leave obvious scary scars around the ears. Is there a way to solve my problems with very small scars?

Doctor Answers 54

What kind of Facelift Leaves Smallest Scars with best Possible Results?

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The facelift performed by the surgeon with the most expertise, training, experience and patience will leave you with the best results.
 The facelift procedure involves incisions that skirt the contour of the ears, using the anatomy of the ear to help conceal them. For a full facelift, the incision starts in the sideburn area, follows the contours of the junction of the ear with the face, curves behind the earlobe into the recess between the posterior ear and the neck/scalp, and then extends into the hairline posteriorly at the top of the ear. When I make these incisions, I design them so that, once fully healed, they may be difficult for even a hairdresser to detect. That goal can often be achieved, and it requires meticulous attention to every centimeter of the closure.
Following surgery, many surgeons, myself included will offer complimentary V-Beam laser treatments to help speed healing and minimize scarring.  Most plastic surgeons also make  topical silicone gel treatments available to help minimize scarring. Close monitoring following surgery is imperative. If scars start start to thicken, they can be treated with steroid injection. But early treatment is key.  You don't want to wait until a scar is a problem before you begin receiving treatment 

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Facelift with the smallest scars

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Scarring from a facelift is the result of many different factors, such as placement of the incision, skill of the surgeon, healing properties of each individual, and tension placed on the skin. A lot of tension on the incision site will give wide scars. If the sutures are left in too long, railroad tracking will result. While a mini lift has shorter incisions, it gives less of a result than a full face/neck lift. If there is a lot of excess skin, a longer incision will be needed to adequately address the excess skin that needs to be trimmed back. A mini lift will be a shorter incision. Part of the incision in front of the ears can be hidden behind the tragus and the one behind the ear is usually located in the postauricular sulcus.  

Smallest scar facelift

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The smallest scars are attained by the best surgeons.  They are not attained by a specific technique..

The very next day after surgery with a top surgeon, patients look into the mirror and barely see their incisions.

Years after a mini lift performed by a journeyman surgeon or a non specialist, patients may see highly visible, stretched scars. 

This is especially true of short scar facelifts, not because these techniques are inherently bad, but because of the doctors who are attracted to the marketing of the technique.

On RealSelf, the reviews of branded mini lifts are quite bad. Theoretically these have small incisions; why are patients so unsatisfied?

The answer is often that short scar facelifts are performed as a marketing tool to attract prospective patients.  Glitzy ads, infomercials, big promises, but terrible reviews.  However, one vital component is missing:  operator experience and skill level.

There is simply no substitute for a top plastic surgeon performing a facelift.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 188 reviews

Facelift Scars

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On the contrary, most good facelifts should not leave obvious scars.  A skilled cosmetic surgeon can rejuvenate your neck in jowls via well hidden incisions, when closed with good surgical technique, heal well enough that they should not be obvious.  I suggest you seek out a skilled surgeon who performs many facelifts a year, and ask to see before and after pictures to see if results of postoperative healing are acceptable to you.  Good Luck...Dr. Corrado

Anthony Corrado, DO
Philadelphia Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Facelift Incisions

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Surgical scars are placed as inconspicuously as possible...typically depending on your anatomy (hairline position with respect to lateral eyebrow, size and position of tragus which lies just in front of the ear, amount of skin I remove from the neck, etc.)...therefore it is not the technique but the patient's anatomy that guides the scar planning.

I perform the MACS lift (minimal access cranial suspension) which is a short scar technique in most patients; however in the neck, I was taught by Dr. Joel Feldman to perform the corset platysmaplasty with a retro-auricular scar (behind the ear) that DOES NOT cross visibly behind the ear or along the hairline...this is the scar I thinks really cripples facelift patients as far as hair length and the ability to wear the hair up.

See a board certified Plastic Surgeon or two/three with tremendous facial surgery experience. Ask them where they will plan on placing the scar....Buyer Beware with Lifestyle and Thread Lifting, I have not seen convincing longterm results and have to revise a number...maybe just my experience though!

Good Luck!

Dr. C.

John Philip Connors III, MD, FACS
Atlanta Plastic Surgeon

Facelift: Small Scars

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I certainly understand your concern about minimizing scars. After all cosmetic surgery should be just that: a procedure that enhances appearance.  An obvious scar would detract from one's appearance.

Yet, disproportionately prioritizing the smallest possible scar may leave you with unsatisfactory or inadequate results.

Many patients have made the error of choosing a technique, rather than choosing the right surgeon, who has years of training and experience to guide the choice of the optimal technique for that particular patient.  Each individual has unique desires and requirements for a successful outcome. 

In your consultations with plastic surgeons, ask the surgeon what incisions and technique each would recommend for you and why. There are always trade-offs in cosmetic surgery. Choosing the right surgeon to guide your decision is the key to your successful outcome.

Facelifts are customized to minimize scars and maximize results

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Every face is different and every person ages differently, so there is no single answer to the question of what facelift is best with the least scar. That is why it is important not to decide about the type of facelift you want without seeing an experienced plastic surgeon. There are newer techniques that are designed to accomplish more with shorter scars so you should have some good options. In any case, facelift scars should not be obvious. For younger patients (40's-early 50's) nonsurgical treatments such as Ulthera might be enough. I was just in Kyoto a few weeks ago giving a talk on the subject and there are some very accomplished doctors doing Ulthera.

Facelift approach with the smallest scar ?

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Thank you for your question.

Most patients are understandably apprehensive about the facelift incision and resulting scar. However, following recovery, the scar is rarely a cause for concern.

Ask yourself the following questions. Is the scar length your most important criterion ? Are you primarily interested in having as short a scar as possible, even if that scar length compromises the result of your lift. Or, would you prefer to have a superior result if that means a somewhat longer scar ?

Many 'short scar' techniques, attempt to minimize the scar. However, the result is usually compromised. In the case of a short scar and minimal lift, the result is often unsatisfying due to a lack of noticeable improvement. In the case of a short scar with an appropriate lift, unavoidable 'bunching' of tissue results, which can contribute to an unnatural appearance. A longer incision and resulting scar may be appropriate when a significant lift is undertaken.

Lasting bunching is rarely encountered when the incision length is appropriately designed and performed. When an appropriately long incision is utilized, bunching is minimized. Once patients are educated about this, most understand and approve of the trade-off between a longer incision with less bunching and an often superior result.

In most healthy people without a history of healing irregularities, the surgical scars resulting from a well-performed facelift are rarely an issue. Incisions are designed to result in scars that are concealed within natural curvatures around the ear and hairline. Full scar maturation takes many months. However, most patients consider those scars to be acceptable with makeup within 1-2 weeks, and acceptable without makeup in 1-2 months. Once mature, most scars are imperceptible in normal social interactions, although not entirely invisible upon closer scrutiny. The design and performance of the facelift incision are some of the factors that influences a natural result and the desirability of a facelift surgeon.

James M. Pearson, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 132 reviews

If Deemed a Candidate, Lite-lift™ May Be an Ideal Option

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If you are deemed a candidate, Lite-lift™ may be an option for you. Patients who desire facial rejuvenation that is affordable, quick, and effective should consider the Lite-lift™. The LiteLift™ is an innovative facelift developed by board-certified plastic surgeons Dr. Larry Nichter and myself which benefits many male patients. The goal of the #LiteLift is to provide a less invasive natural looking option for both men and women desiring to refresh their appearance with less downtime and risks. The LiteLift® is a “real” facelift, which does address the underlying muscle, tissue and overlying skin.
The technique requires limited incisions and takes a vertical lifting approach, in contrast to the traditional facelift, which requires extensive incisions and lifts or pulls the face towards the ears horizontally. The modern techniques used allow us to perform most LiteLift® procedures in the office under local anesthesia. Also, removing the risk of general anesthesia opens the door for more people to pursue facial surgery. All too often people do not move forward with undergoing the desires facelift surgery due to their overwhelming fear of the risks associated with general anesthesia.

This is a modified facelift that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.

The best candidates for #LiteLift are non-smoking patients 35-60 years old with early changes of the lower face and the neck. But whose skin has elasticity with well defined bone structure. Older patients who cannot or do not wish to have a longer operation or general anesthetic may also be a candidate for a Lite Lift™.
If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives.

What Kind of Facelift Leaves the Smallest Scar with the Best Possible Results?

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A scar from facelift surgery can include visible wide scars on the face, elongated pixie shaped ears as well as loss of hairs or stepped pattern in the hairline. These results are avoidable by using specialized surgical techniques and meticulous attention to detail.

For a natural looking facelift and rejuvenation avoid scars:
  • Elevation of the deeper layers of the face (including the SMAS, superficial musculoaponeurotic system) this requires specialized surgical techniques and hours of surgery to complete.
  • Meticulous attention to detail is required, to ensure that scarring is limited to a fine line and lifting does not alter natural hair lines. With meticulous techniques these issues can be avoided. Excessive pulling of the skin can result in distortion of the ears and wide scars that are hallmarks of surgery, with meticulous surgical technique these can be avoided.
  • Often natural looking rejuvenation requires additional treatments to give the best possible result. Common additional procedures include fat transfer, skin resurfacing and blepharoplasty.
  • Rarely, there are medical conditions that can result in poor healing and increased scarring, such as keloid scarring. If you know that you have such a condition always inform your surgeon.
With the factors above scarring from facelift surgery can be avoided, once scars have been made on the face, they are more difficult to treat and may require revision facelift surgery to reduce tension on the healing skin or the use of laser resurfacing.

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.