Options for Correcting SMAS Face Lift Scars?

I had a SMAS Face Lift, Brow Lift, and Liposuction under my chin in June 2008. The scar in front of my ear is perfectly hidden on one side, but is very visible on the other side. What can be done about this? I have been given cortisone injections on my neck and behind my ears because the incision scars were thick. Do I need scar revision or some kind of laser treatment for these scars?

Doctor Answers 46

Scar after a facelift

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wait a year and simply revise scar with a little tightening if needed. you can do it on both sides at the same time, under local and I don't generally cgarge my pts for the "touch up". don't bother with injections in front of the ear, likewise with lasers. good luck

Boca Raton Plastic Surgeon

Invisible Scars: the holy grail of plastic surgery!

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Making scars disappear is the holy grail of plastic surgery - we are still searching for it! Scars that are thick, or "hypertrophic," are problems once they've developed, and patients who develop unsightly scars will likely heal the same way with simple scar revision unless additional treatments are performed. There's no quick fix: waiting 1-2 years, using massage techniques, silicone gel sheeting, or topical creams have good intentions - and they can't hurt - but they may be ineffective in the long term. However, scars that stand out from the surrounding skin can be made much less noticeable through laser therapy. Depending on the appearance of your scar, laser treatment can address unwanted pinkness or pigmentation of the scar, and can smooth, soften, and flatten the scar, as well. One thing is for certain: be sure to seek out a board-certified dermatologist or plastic surgeon with extensive experience specifically in scar treatment - gentle energy settings need to be used in treating scar tissue so as not to re-trigger the skin-healing response that initiated the scar formation in the first place. This can be as much an art as a science.

Scar revision for SMAS Facelift

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Scar revisions are quite commonly needed for SMAS plication lifts and are very very easy to perform in most cases just using local anesthesia.  The options are scar excision, steroid injections, laser resurfacing, skin flap movement and even hair transplantation.  

The type of revision needed just depends on how the scars look and where they are located. 

Ben Talei, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 50 reviews

Scar Revision first followed by kenalog / lasers

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At this stage it will probably be best for you to have a scar revision procedure done. While this is a surgical approach it is not as intensive as having a facelift done.

It will be important for your surgeon to create some laxity under the skin surrounding the scar so as to minimize tension as it heals. 

Close followup will be important after the revision as kenalog injections, lasers or silicone sheeting can be used to help the healing move along well.

Wishing you well,

Dr. J

Kamran Jafri, MD
New York Facial Plastic Surgeon

Scar revision of a facelift scar that is thick and red

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Scar revision surgery + a combination of fractional co2 laser and pulsed dye laser will help the scar.  I have performed both surgical and non surgical treatments with great success.

Bad scars after a facelift are very unusual but can be revised.

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Do not laser your scars.  It doesn't work.  Bad scars after facelift are frankly rare.   The skin should not be under significant tension after the operation.  If the scars have spread or are thickened after 2 years, you definitely should have a revision. Careful post-operative management should leave you with a good result. I would like to see a picture of your scars.

Scar revision

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Nobody is  quite sure why one side would heal well and the other side doesn't. I have performed many vertical Vector SMAS facelifts and rarely this occurs. It sounds to me that a scar revision surgery may be your best bet.

Scar after a facelift

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If a post-surgical scar persists for a year, you may want to consider scar revision surgery. While a scar cannot be completely erased, a scar revision procedure can minimize its prominence. Surgical techniques include skin flaps and grafting, as well as removal of the scar tissue. Depending on the appearance and nature of the scar, another non-surgical procedure may also be an option. It is best to have your scar evaluated by a plastic surgeon who is skilled in scar revision procedures. Your surgeon will consider factors such as skin type and ethnicity, your healing rate, and age before recommending the best way to correct your scarring.

Scar options after facelift

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The appearance of the scar really determines the best way of treating it.  In general, however, if the scar creates a shadow, and color is not a problem, simply adding filler will help.  If the color is a problem, usually scar revision is the best solution.  Removing the scar and then bringing back the normal skin together would give you the best improvement.  Scar massage, steroid injections, and silcone gel/strips help for the first year, but after that, I would consider another option. 

Facelift scars

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Thank you for your question. While scars will always be present, much can be done to make them as subtle as possible. Facelift incisions can be managed using a multimodal approach:
1) Scar massage - starting as soon as the surgical dressings come off and the incisions are sealed
2) Silicone sheets or scar gels for about six months to year
3) Fractionated lasers to help blend the scar into the background - done as a series, starting about 4 weeks after surgery and repeated every four weeks for six months.
4) Sunscreen to prevent the scars from darkening

Your incisions should be very subtle based on the placement of the incisions, but may need a full 6 months to 1 year or more to fade.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.