Concerned about scarring in front of sideburn, but I don't want to have my sideburn pulled back either. Lower Facelift Advice?

Great question you posed and a common one that comes up. In short here are the major pros and cons in my eyes:

Traditional incision site is in the temple hair bearing area - Pros- hidden  Cons: if you end up with a widened scar and hair loss, plus in all cases the sideburn is pulled vertically and ends up being higher than before - sometimes to the top of your ear. This is the most common method used

 

Incision at the hair line - in this case it is critical that the surgeon bevels the incision and makes it a mm or so just behind the hairline retaining follicles.

Pros - hair often grows back through the scar and no distortion of sideburn length

Cons - pink for several months to a year (easy to conceal with make up) and if hair doesn't grow back fine white line in most cases. This is a newer technique and one I personally favor in patients with high sideburns, secondary facelifts, and patients who request it. 

 

Depending on the training of your surgeons and the facelift technques they feel comfortable with in the treatment of your face, you will get a different opinion from every facelift doctor that you meet.  The doctor who is right for you is the one who has a proven track record for giving you major improvements in the areas you want addressed.  Many times different techniques achieve the same look.  Be sure to view plenty of before and after photos, talk to former patients, and make sure your doctor is experienced.  In the end, you have to get along with your doctor, so a caring personality really matters.  Good luck!

Hello,

There are different approaches to rejuvenating the lower face and I don't blame you for being confused. It is difficult to understand the different approaches, especially when different surgeons are recommending different options. I am sure they all have your best interest in mind. The reason there are so many approaches to incisions and placement is because not one of them is better for all patients. There are pros and cons to incisions in front and below the hairline, and it really comes down to what you are willing to accept. I personally prefer to keep all of the facial incisions in front of the temporal hairline (sideburns) to avoid pulling the side burn up as this looks unnatural. 

At our practice, we refer to our lower facelifts as either long incision or short incision. The long incision provides more tightening to the neck area, but does require incisions that can be seen when wearing a pony tail. If you would accept a less tight neck, then you may be a candidate for the short incision method instead. It is up to you to decide what your personal priorities are when it comes to how you want to wear your hair post surgery, and how tight you want your neck to be.

You can find out more about long incision and short incision lower facelift by following the link.

Sincerely,

Dr. Buonassisi