A doctor mentioned a short scar facelift. Please describe this procedure and how is it different from a traditional facelift? Also, is it true that in a traditional facelift, they actually lift the skin and re-drape it after stapling underlying tissue? Is it true that they have to put screws in the skull as well? Please explain this procedure.
Please Describe the Short Scar Facelift
Doctor Answers 27
Short Scar Facelift
The differences are significant. The idea of a facelift with a ‘short scar’ appeals to the consumer, but the term is quite misleading. It leads one to believe that you can get the same result with a shorter scar, and the reality is that you can’t. It sounds too good to be true, and it is. In fact the logic behind these procedures really defies logic.
The ‘short scar’ and MACS facelifts eliminate the incisions behind the ears, which – if carried out correctly – should result in invisible scars. Scars behind the ears, when placed where they belong (in the depth of the crease behind the ears and hidden in the occipital hairline) are either invisible or very difficult to detect. So why all the fuss? Because a lot of surgeons are not meticulous about making and closing the incisions behind the ears, which has given these scars a bad name. But there is no reason it has to be that way.
Hey, what are those odd scars in front of your ears?
The MACS facelift moves ALL of the skin excision into the area in front of the ear, which forces the surgeon to create a gathered, pleated and essentially impossible-to-conceal closure around the patient’s sideburns. With a traditional facelift closure the scar in this area may be placed behind the temporal hairline, where it is invisible, or at the hairline, where it can be closed invisibly because much or most of the skin excess has been removed behind the ears.
The MACS lift does something that is completely counter-intuitive: moving the surgical scars from areas where they are easily concealed to areas where they are almost impossible to conceal. The term ‘short scar facelift’ is really misleading, as you go from longer scars that can be completely concealed to shorter scars that can’t. So effectively, in terms of visible scars, the ‘short scar’ facelifts are in reality LONGER VISIBLE SCAR facelifts.
They are also - as they undermine less skin and undertreat or completely fail to treat neck skin laxity - less of a facelift. And not really a necklift at all, which all facelifts should be.
Um, your neck still looks old.
There’s just no way around it. In patients with neck skin laxity, if you fail to fully mobilize the skin of the neck as well as below and behind the ears, then it is physically impossible to create a smooth, dramatic and truly rejuvenation neck contour. Unless, as a cosmetic plastic surgeon, you are willing to leave a pile of skin folds and pleats in the lateral neck below the ear. I have yet to meet the patient who will be happy with a sort-of youthful anterior neck but an aged and post-surgical looking lateral neck. And I would derive no joy from providing a patient with that kind of surgical result.
Spend some time carefully studying ‘short scar’ facelift (‘MACS lift’ ‘S-lift’, ‘weekend facelift’, ‘Lifestyle Lift’, etc.) before and after photos. You will see, over and over, the following features:
Easily visible scars in the sideburn area and in front of the ears
Distortion of normal sideburn anatomy
Gathering of skin (pleats and wrinkles) below the ears
Undesirable skin contours below the jawline and in the neck
Little to no improvement in neck skin laxity
f course you may also see unfavorable scars in traditional facelift ‘before and after’ photos, so you need to carefully research the physician or physicians you decide to consult with for a facelift procedure. If a surgeon has mastered the High-SMAS face and necklift procedure, the scars should be close to invisible and often undetectable. This procedure, combined with structural fat grafting, rejuvenates the face in a very dramatic yet still very natural-appearing way. And with scars that allow a patient to wear their hair any way they please, including pulled back in a ponytail or gathered up above the ears.
The scar war
A short scar face lift is a face lift that is performed through a small scar( less than the traditional pre-auricular/ post auricular incision).
Short scar surgery became very popular in the late 1990 and is obviously very tempting. Endoscopic techniques allowed some of these surgeries to performed with very small scars e.g forehead lift.
It became clear after few years that the success of these mini lifts depends on the patient anatomy and the degree of sagging.We performed a study in 2002 looking at 200 face lifts, this group showed an improved benefit of short scar technique in the group of patients with less degree of tissue aging and in general younger patients.
My recommendation is to let your surgeon access you tissues and decide what would be the best procedure for you. Best of luck!
What is a short scar facelift?
That being said, the best candidates for a short scar facelift are patients with minimal excess skin and essentially no neck or jowling problems. As you can imagine, this is a small population.
I recommend a formal consultation with a board certified plastic surgeon so your goals can be discussed and an exam performed so an individualized recommendation be made. Good luck!
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Short Scar Facelift
Short scar facelift has its place in the aging face surgeon's tool box. The key here is to determine if you are a proper candidate for such a lift. The scar provides access to the face for the lifting portion. In some patients, especially those with a large amount of neck skin, the short scar lift may not be the best option.
While the short scar provides access to the face, the underlying technique of lifting the face should still focus on lifting the deeper tissues of the face into a better position.
For more information on short scar lifts, see link below.
Short scar facelift is limited in the extent of the incision and amount of dissection
There are many different variations of a short scar face lift. This approach differs from traditional face lifting approaches by the limits in the length of the incision, the depth of incision, the amount of dissection, and extent of improvement. It really depends on who you go to. There are ways to limit the length of skin incision and still achieve amazing results through tissue distribution.
Many surgeons out there are making the short scar facelift more a "short cut" face lift where corners are cut and the results are essentially much less satisfactory. However, there are some very knowledgeable surgeons out there that can use a short scar and do amazing things. Short scar facelifts usually entail also superficial dissection to avoid exposing facial nerves and is deemed safer by many.
Thanks for reading!
Short scar facelift usually means short recovery time
The short scar facelift or mini lift can produce substantial and lasting improvement for appropriate candidates, and has the advantage of a short recovery time as well. Because the incision and operation is shortened there is less swelling and bruising and recovery can be shortened to several days rather than a week or longer. The short scar facelift works well for individuals with moderate laxity in the neck and jowl.
Age, in fact, is not the limiting factor as we all age differently, though a very loose neck, a dreaded turkey neck, will most often require the full facelift approach. The full facelift differs in that the incision runs up behind the ear into the hairline in back which allows a very full correction of the neck when needed.
The key to facial rejuvenation is safety, substantial improvement, with a manageable recovery, and in this day and age a short recovery is a must.
Best of luck,
Peter E Johnson MD
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