Is it inevitable that facelift scars will stretch over time?

Dear hearteaseThank you for your question!  The incisions/scarring generally mature at 3 to 6 months after surgery and continue to face up to a year.They will not change much after that point.  If there is a lot of tension on the closure- there will be changes in the scars early after surgery- they will drift down and spread and possibly thicken.With Warm RegardsTrevor M Born MD

Hi there. Thanks for your question. You seem to already be familiar with the basic tenets of good wound healing and fine scar formation. There is obviously a genetic component to the final scar formation, which cannot be accounted for surgical technique. However, there are several manoeuvres that are fundamental to good scar formation. Placement of the incision is critical to producing well-concealed inconspicuous scars. Another key issue is avoidance of excessive skin - this used to be a favoured approach to lifting the face but modern techniques do not rely on skin removal at all. With a conservative skin excision, the two wounds line up without tension and the resultant scar should not stretch over time. Good luck!

Facelift incisions, if placed correctly and closed with minimal tension and meticulous technique, should not stretch or widen.  Some exceptions to this are patients with skin conditions or genetic factors which may alter normal wound healing. Your plastic surgeon and discuss this in detail with you.

Positioning the skin without tension combined with proper technique during incision closure will prevent stretching over time. Over course, there is a small percentage of patients who, either due to health conditions or family history, may not have ideal wound healing but this is independent of surgical technique. Be sure to ask for before and after photos from your surgeon during initial consultations to get an idea of how patients recover over time. Good luck!

 As you have recognized the culprit in the widening of scars is tension.  Incisions used for facelifts can be divided into above the ear or along the anterior hairline, in front of the ear, behind the ear,  and along  or in the posterior hairline. Of these the ones with the greatest potential for widening, are the anterior and posterior hairline incisions.  The use of deep tissue suturing can be helpful in preventing excess tension , but is not foolproof.  Regards, Dr. Kiener