Crease under left ear and skin under neck. Can this be improved? (Photo)

Question

I had facelift and neck lift done in august 2021. I had revision done on two seprate occasions to address more severe crease and to have vertical bands tied. I still have a crease on left side only and loose skin under neck chin. Can this be improved?

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

Mats Hagstrom, MD (license on probation) · Answer

To make quality assessment regarding the outcome of a plastic surgery procedure we generally need to see a complete set of proper before and after pictures. Because facelift are done differently by different plastic surgeons, it would also be important to have access to the opera to report to understand what kind of facelift you had done.
 I think some of the issues with your outcome has to do with the vectoring of the pull of the tissues.
With a typical SMAS facelift, the SMAS layer is typically pulled in a more superior direction or up and slightly towards the back while the skin layer is generally pulled more straight back. Once the procedure is performed, it difficult to redo the design of the primary operation.
 There appears to be some contour irregularities of your platysma muscle that can probably be addressed.
The skin folds behind your ear may be more challenging. Perhaps these could be improved with a very careful use of small amounts of filler using a very send needles.I’ve had good results in the past treating skin lines, similar to yours, using dilute HA, fillers. 
The outcome of most plastic surgery procedures are based on the patient’s candidacy for the procedure and the skill and experience of the provider.
An accurate assessment requires very good information and input to understand what was done.
If you’re not getting the care you need from your current provider then I suggest you schedule in person second opinion consultation with other providers in your community.
For second opinion, consultations come prepared bringing with you a complete set of proper before and after pictures and a copy of your operative reports, including upper to reports for your revision procedures, and before, and after pictures of these procedures as well.
In other words, you should probably get a complete copy of your entire medical record And bring that with you for a second opinion consultation.
Best,
Mats Hagstrom, MD

Crease under left ear and skin under neck. Can this be improved? (Photo)

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Crease under left ear and skin under neck. Can this be improved? (Photo)

Answers (2)

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