Help to Remove Facelift Keloids for a "Light Lift"

You will see a common theme among patients who have undergone minilifts: hypertrophic or keloidal scarring.
Why would a minilift result in large scarring?
When incisions are closed after a real facelift performed by an expert facelift surgeon, they are closed with minimal tension. That means not too tightly at the place where the sutures are placed. The reason for this is simple: wounds that are closed under tension stretch, forming thick scars.
So ironically, to avoid the burden of having a real facelift- which in reality is 48 hours of healing time but admittedly much greater pricetag-- patients incur more scarring and deformation, not less.
In the short term, scarring can be minimized by kenalog injections, various creams and gels, and application of topical treatments (each of which has specific therapeutic windows).
After 6 months, scars are usually considered mature enough to be revised.
Revising minilift scars usually involves converting the minilift to a real facelift, reforming the delicate earlobe, tragus, hairline details so they are much less detectable, and sometimes undetectable.
Plastic surgeons who specialize in revision facelifts are your best bet for consultation regarding the above issues.

Hello! Thank you for the question! It is common for scars to fully mature for up to a year. In the meantime, there are a few things that may help to ameliorate your incision/scar. The most proven (as well as cheapest) modality is simple scar massage. Applying pressure and massaging the well-healed scar has been shown to improve the appearance as it breaks up the scar tissue, hopefully producing the finest scar as possible. Other things that have been shown to add some benefit, albeit controversial, are silicone sheets, hydration, and topical steroids. In addition, avoidance of direct sunlight to the incision will significantly help the appearance as they tend to discolor with UV light during the healing process. If unsightly scars are still present after approximately a year's time, other things that your surgeon may consider are intralesional steroid injections, laser, or just surgical revision of the scar itself.Hope that this helps! Best wishes!

Best Scar Management Practice – Advice from Dr. Larry Nichter:

In your particular case it sounds like you have a hypertrophic scar rather than a keloid. Either way my advice is similar. At this late point you may well need a scar revision, a minor office procedure to remove your scar and replace it with a new one. Below are what I feel is important to prevent a future bad scar: 
Best Scar Management is important to minimize or completely hide from view, the tell tale signs of surgery – namely, scars. Both you and your surgeon want you to have the most minimal scarring possible from your surgery.  Patients with scars that are enlarged or not healing well after surgery can be from many causes. Unsightly scars are most commonly due to genetics, underlying medical conditions or improper scar/wound care. The last part is very important and patients can make a noticeable difference in their scars’ appearance by following best scar management practices. Here are some simple tips.
Scar Management tips:
1- Minimize tension on the scar – Steri Strips and/or surgical tape are often placed in non-hair bearing areas to minimize tension and keep pressure over the scar.  This minimizes the  stress that  can pull the scar apart (dehiscence) creating a wound and  delaying healing time, and can make the scar wider, or more “ropy”.
2– Keep your incision site/scar clean to prevent infection. Follow your surgeon’s wound care instructions to the letter with out modification. NEVER apply different products then recommended without first discussing them with your surgeon. This is especially important during the first few weeks. If there are any signs of infection contact your surgeon’s office immediately and/or see your doctor or his nurse immediately. Typical signs of infection may include redness outside the immediate incision site, asymmetric swelling, and drainage, of pus, fever, chills, and “feeling sick”.
3. –Protect your scars from the sun - staying out of the sun is the best advice. Minimal exposure to sunlight is prevents hyperpigmentation (permanently turning brown) and other problems that can make the scar more noticeable. Sunscreen, at least 30 SPF and an overlying make camouflage make up additionally protects the scar from the suns harmful rays. This advice is especially important the first year following your surgery.  .
4. – Use specific scar maturation products recommended by your surgeon. Patients seem to have their own opinions on this touting everything from Pure Vit E, Coco butter, to Aloe Vera, etc but most have minimal benefit other than keeping the scar hydrated. Although hydration is important there are better, scientifically studied products with greater efficacy. Most of the scientific articles written about this subject indicate that topical silicone gel or silicone sheets work the best.  There are a lot of products to choose from, but silicone should be one of the key ingredients. Although Mederma, an onion extract derivative active ingredient rather than mainly silicone based may help, primarily silicone based products are better and many also contain other ingredients that may be synergistic (hydrocortisone or other steroid, Vitamin E, Sunscreen,etc). At the present time I prefer BioCorneum  or Kelo-Cote products and if the reader has problems obtaining these they can call my office. Patient compliance is also critical – use often and according to directions or it will not work optimally. NEVER apply products without first discussing them with your surgeon.
5. – Monitor to make sure your scar is progressing optimally. Keep your scheduled follow-up appointments with your surgeon to verify that your scars are maturing as expected.  Occasionally if indicated you may need a topical or injection of a steroid preparation or even a series of  injections (5-FU and/or Steroids) or laser treatments  to treat or  prevent scar hypertrophy or keloid formation (red raised scars), or other topical medicines to treat post inflammatory hyperpigmentation (brown scars) with prescription creams and possible laser treatments.

Scar revision after a facelift procedure often requires a more extensive facelifting procedure to remove enough of the scar.  You need to find an experienced facial plastic surgeon or plastic surgeon to help with improving or eliminating the scar formation.  If the scars are unable to be treated in one setting, a staged, second procedure may be required to get the best result.   Best of luck!

Dear Cantonie, It seems that you have hypertrophic scars rather than Keloids. Hypertrophic scars are simply thicker, wider scars and they start to appear two to three weeks post surgery and stop growing. On the other hands keloid scars are pathological where the scar continues to grow beyond its original borders and they get very large. I would recommend you to see a plastic surgeon in your area. He or she will most likely to inject the area with Kenalog for at least 3 sessions and recommend scar gels such as Kelocote and topical steroid. Laser is a good option as well. If these treatments are not affective, there are other options available that I would leave that to treating physician.

There are a few ways to help with Keloid scars.  Most Doctors first attempt would be to do a Kenalog injection. This can help the scars appearance. Also, using silicone gel or sheeting can help to smooth out the scars. If they are very irritating, I would recommend seeing someone in your area for help. Good Luck!