Is It the Norm to Pleat the Skin Behind the Ears in Lower Face Lift Surgery?

   Pleats of a minor nature tend to smoothe out in several months, but a physical exam would be necessary to determine the likelihood of this scenario.  Kenneth Hughes, MD facelift Los Angeles, CA

When the skin is separated from the underlying tissues during surgery, small sensory #nerves are cut. Varying degrees of numbness will be present after surgery and will improve gradually as the nerves reconnect to the skin. This process can take from 2-6 months for face, neck and cheeks, and to 9-12 months for the forehead and scalp. Muscle weakness may also be present around the mouth especially if liposuction is used. This typically recovers fully in the months after surgery. 

As the nerves regenerate, the itching, burning, tingling and shooting #sensations will occur. Ice, moisturizers and gentle #massaging are helpful during this phase of the #healing process. Frequently there is a tight feeling in the neck, jawline and cheek after a facelift. During surgery, not only the skin but the underlying muscles are tightened to create a better and longer lasting result. Additionally, the #swelling will move downward in the first week and the neck will feel even tighter. Do not be alarmed: the sensation will decrease during the first month. Some degree of firmness or lumpiness under the skin is normal after surgery and will resolve with time. Local massage will speed resolution of this problem, which normally takes 2-4 months to disappear completely. If you have certain concerns about the procedures and #healing process, it is recommended to call your board-certified surgeon or their medical staff and discuss those #concerns.

Pleats can occur with any lower face/neck lift and fortunately resolve on their own within 6 months. We all try to hide incisions and give the most natural look to the skin but sometimes pleats just happen. Your doc will follow up with you and make sure the pleats resolve with time or he/she will just smooth them out easily. Most lower face/neck lifts can be done under local anesthesia for roughly $6-8500 and there tend to be less pleating of the skin when you can be sat up and turned during the procedure because you are awake and comfortable.  Sincerely,

David Hansen,MD

It is not normal to have pleats in the post-auricular area after a facelift.  The reason this pleat occurred is due to the posterior to anterior rotation of the post-auricular skin flap with placement of the incision behind the ears.  The only way to have this fixed is to redo the lower portion of the face/neck lift and re-drape the skin in the appropriate fashion.

It sounds you had short scar face lift. May have leats behind the ears. Small pleats will resolve, large pleats may require revision under local anesthesia.

The problem with all "short scar" surgeries is that in order to make the scars shorter than they might have actually needed to be for a smooth result, the skin is bunched up and this may leave pleats.  These can soften or they may be permanent.

The other thing that can leave pleats in a facelift is how the skin is moved and pulled when there is a lot of sun damage.  The more sun damage, the less pull you can make and the more carefully the surgeon needs to redrape the skin.