Do I Have Any Options for Improving Bad Temporal Hairline Facelift Scar Placement?

Question

I had a SMAS facelift w/ fat grafting on 5/20/11. I am 2-wks post-surgery. Had immediate swelling/bruising which has subsided but is still present. My primary concern is the placement of the temporal hairline incisions. The scars are thick/lumpy/gathered in a prominent position. Although I have long hair, w/ normal movement my temporal hairline is usually visible. I removed the bandages yesterday and am in shock. My original surgeon is a long distance away. I am in the Los Angeles area.

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Vivek Bansal, MD · Answer

See a Board Certified Plastic Surgeon for advice on how this can be optimized for healing, and consider another treatment only when the time is optimal.

Mohsen Tavoussi, MD, DO · Answer

Let the healing complete in 6-9 months so that you can make a better judgement about the scars. Occasionally, the scars are lighter than the surrounding skin and other options are available to camouflage it.

Michael G. Brandt, MD · Answer

Hi there.  Give your incisions some time to heal. 

	Of course its hard to tell strictly on photos, but your incisions appear to be "just right" for having undergone a facelift two-weeks ago.  The height and location of the incisions appears to be reasonable.   Incisions and their resultant scars go through a maturation process that can take up to 12 months.  I'm sure your scars will look great in a few weeks; so I'd suggest giving them some time.   

	In the in-term, as I'm sure your provider has suggested, you may want to consider using a silicone based scar ointment/cream and some sunscreen to the area to help the scars heal and avoid any colour changes that may come from too much sun exposure - the sun can turn the scar dark.  Biocorneum is one of many options available.  Additionally, I'd suggest massaging the wounds to help them flatten and re-orient the collagen fibers.  You can massage the scars as often as you'd like - you won't hurt a thing.

	All the best.

Sumit Bapna, MD · Answer

Kristy7, it has only been 2 weeks since your surgery, so the scars will surely improve. As the edema to the surrounding skin subsides the skin will look less gathered and thick. This make take several weeks to months to occur. The incision looks like it was placed just in front of the hairline. If this was done correctly, hair should grow through the scar and make it less noticeable with time as well. If there is still a problem with the scar after a year, you can consider scar revision or follicular unit hair transplantation to disguise it.

Do I Have Any Options for Improving Bad Temporal Hairline Facelift Scar Placement?

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