At eight weeks, you could start treatment with a scar laser like the Cynosure Lux 1540. This is designed to soften the scar and inhibit it from getting hypertrophic over the next two months. Keep massaging the neck. Keep in mind that at six weeks,the tissues are very actively healing and there is no active intervention to do. Eventually what appears to be dog ears at the end can soften and blend into the plane of the neck. If not then after 6-8 months some revision might help, without extending them any further. Post-op neck hardening, recurrent banding and firmness of the neck is a known problem with necklifts. Many plastic surgeons prefer not to open the neck during a facelift for this reason. Corset platysmaplasties seem to work well in some plastic surgeons hands, but I personally feel that they tend to make the neck look unnaturally tight and contoured. In any case, patience will be needed and your plastic surgeon can be supportive to you during this time.
Your situation is unusual in my experience and I'm uncertain why such a long scar was necessary. The good news is that I do expect it to soften and fade in visibility over the next six months time. It may actually become temporarily a little more prominent at the 12 week mark but should then soften and reduce its prominence. In the interim you might gently massage the incision and apply silicone gel (available at most drug stores).Best wishes,Jon A Perlman MD FACS
Certified, American Board of Plastic Surgery
Extreme Makeover Surgeon ABC TV
Best of Los Angeles Award 2015, 2016
Beverly Hills, Ca
Hello ch823333 - Thanks for your question. I'm sorry for your difficulties. I myself have had to place this incision a couple of times in my career and each time it was with trepidation. After 2000 face and necklifts I've seen all kinds of variations on postoperative necks. You are smart to continue with massage and silicone sheeting. At 8 weeks, the scar is very young and will need much more time to mature. Fractional laser resurfacing, IPL, and microneedling with PRP are all great options to help your scar modulate nicely. Work closely with your surgeon and trial these options for a nonsurgical way to improve the scar to get it to a satisfactory endpoint. Good luck, Dr. Shah
Lasers, subcision and fillers can be used to improve this. Microneedling/PRP often helps. An in person consultation is needed. Best, Dr. Emer.
for being that long... but if your problems may have required it without redoing the facelift. If so, this is the result of the needs of the procedure. You can smooth the scar out with many modalities if it isn't flat enough for you but you need to allow it to heal at this point and allow the redness to resolve before doing anything else.
In general terms, the scar is somewhat longer than normally used and probably was designed to accommodate skin removal. I do not typically remove skin in this region, because once a corset platysmaplasty is performed, more skin is required to fill a concavity than an oblique neck angle. The scar itself will improve over time, taking up to 1 year to reach steady state. Silicone sheeting won't hurt, but won't likely add a great deal in this circumstance. Time and reassurance from your Surgeon will be the best Medicine.
Dear ch823333, Personally, I have never used an incision like this during a facelift/necklift and my feeling is that when you remove skin from the sub-mental region, you can cause an elongation of the incision and then have what we call (dog ears) at each end. My preferred method is lifting and removing the skin from the post and pre-auricular areas. With that said, continue follow up with your surgeon and discuss options to reduce your scarring including the silicone sheeting, massage, and possible laser therapies. Time is on your side and you should see some improvement. Best regards, Michael V. Elam, M.D.
Sorry you've had such a difficult postoperative experience. 8 weeks is still pretty early in the postoperative period. Scars tend to mature by around 6-12 months (less red, smaller in size, flatter appearing), so I would wait up to 12 months before considering further treatment. Fortunately, if you are not happy with your scar after this "watch-and-wait" period, there are several great options to help improve the appearance of your scar (including but not limited to laser skin resurfacing, fillers, surgical procedures). I recommend visiting a board-certified facial plastic surgeon for a proper exam prior to any interventions.
I think the silicone sheet is a good idea. Eventually the scar will soften and fade. It is too soon to do any revision at this time. I would continue to have your plastic surgeon follow the scar because down the road he may be able to improve upon it.
Good luck to you.
I'm sorry to hear of your unhappy experience. That particular scar probably takes longer than most facial scars to look good, but the odds are it will do fine if given enough time, and that is up to a year. Until then it is best to avoid anything more aggressive than a good silicone scar treatment.