Is it inevitable that facelift scars will stretch over time?

Question

If facelift incisions are done properly and carefully, and not sutured under tension, will they be OK over time (years)? Or is it inevitable that they will stretch and widen regardless of technique? Thank you.

Trevor M. Born, MD · Answer

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

William Townley, MD, FRCS(Plast) · Answer

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!

Jeffrey M. Darrow, MD · Answer

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.

Mark Been, MD · Answer

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!

Ernest Robinson, MD · Answer

Facelift incision become visible because a number of factors with tension being one of them.  If an incision is placed under tension it can widen and thicken over time.Another cause of visible incisions is their placement.  When incisions are placed in hair-bearing regions they may result in alopecia, creating the appearance of a wider scar.  These incision may also distort the hairline, causing more visible scarring.Since the incisions are hidden around the ears they can distort them by pulling on the lobe, the tragus (bump in front of your ear canal opening) and creating a color change.Not all incisions will heal ideally, but care should be taken in closing these incisions.Most of the time they are difficult to notice as time passes.  Discuss these concerns with your Specialist.

R. Scott Yarish, MD · Answer

Facelift scar widening should be very rare.  The areas of tension should be well hidden and the skin itself should be very relaxed at the suture line.  Stretching of the skin/scar itself, is therefore uncommon.  If you have that issue, you should bring it up to your surgeon and have the scars revised.

Louis C. Cutolo, Jr., MD, FACS · Answer

Facelift incisions
should be placed in natural curves in front of the ear. Behind the ears, the incisions
are usually straight. All of the incisions should be placed under minimal
tension. Behind the ears, there is sometimes bunching of excess skin, and this
can lead to scars that might heal in a way that's slightly more noticeable than
those in front of the ear. Stretching is not inevitable, though, and it may be
a result of the technique used to close the wounds.

Inessa Fishman, MD · Answer

Ideal facelift incisions are well-camouflaged in hair-bearing areas and natural creases between face, ear, and neck.  Ideal scars are also narrow and close in color and texture to surrounding skin.  Once healed completely, scars typically do not change much.  An unsatisfactory scar can typically be improved with time, steroid injections, laser, or surgical revisions, among other options.

Daniel Beck, MD · Answer

Heartsease,Regardless of the technique used, well placed scars that are sutured without tension should be almost imperceptible after a full course of healing.  Vigilant care of the scar lines for a full year after the procedure including skin hydration and UV protection are key to optimizing your result.  In a minority of people, genetic factors or inherent qualities of the skin may predispose someone to potential wound healing issues or more significant scarring. Scars on other parts of the body may be an indication of how the facelift incisions will heal/look, but should not be considered absolute representations of the final scar. Discussion of post-operative scar care and thorough evaluation for potential scarring issues should be part of the pre-operative consultation and planning.

Keith Denkler, MD · Answer

Facelift incisions not sutured under tension almost always do well over time and rarely significantly scar or stretch.

Is it inevitable that facelift scars will stretch over time?

Answers (16)

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