Transition Lines from a Facelift?

Can the transition lines from a mid facelift be corrected? Also, what can be done if the skin was pulled to high over the cheekbone and one side is higher than the other? I had my surgery over a year ago. I have lines radiating up from my mouth when I talk and lines going down the side of my face, My doctor called them transition lines. One side is higher than the other and there is a slight indentation near my mouth on the left side from the pulling of the skin. I think he pulled the skin too high over my cheekbones in addition to the asymmetry, My doctor said nothing could be done about-only fillers or fat transfer. i don't feel comfortable posting pictures

Doctor Answers 9

Facelift Transition Lines Can Be Improved

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Your situaition most likely can be improved with time, and judicious revisons.

You may need some surgical revision either major or minor, or discrete filling with Juvederm in the midface to smooth the lines.  Possibly subcsion (subcutaneous needle release) of the  scar lines can relieve adherence to the deeper tissues from the scar bands and help smooth out bands.

Skin care to thicken the collagen or some laser can help thinned skin.

Overall it will take time and patience, so good luck.


Treatment for Transition Lines after Facelift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for the question. Without photos, it is difficult to offer specific advise. From your description, however, it seems that you are seeing issues with the redraping process and the direction of the lift. If the facial skin is pulled too tight, is lifted by itself, or is not released from the underlying ligaments, bunching and "transition lines" or "transition zones" can be seen. Depending on how long ago your surgery was performed, you may be a good candidate for a revision facelift. In my practice, I offer patients in your situation a Deep Plane Facelift -- elevating the muscles and deep connective tissues with the facial skin. This provides a more natural-appearing result with a longer lasting effect. Best of luck!

Transition lines

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

  Unfortunately the best approach to this problem is to once again undrape the facial skin and reposition it in a more evenly and better laid out fashion. This is the only way to get a proper and natural looking correction. It is imperative to wait until enough swelling and healing has taken place in order to make a correct evaluation of the problem and result.

Face lift revision

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Without photos it is difficult to answer your question, but facelift revisions are often very successful.  Discuss your concerns with your surgeon, and if you are not satisfied with his or her plan, get a second opinion from another board certified plastic surgeon.


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It would be beneficial to know how long ago you had your surgery and pictures as well.  That being said I would certainly see the surgeon who performed the initial surgery to ask there advice.  It is important that the surgeon be a board certified plastic surgeon.

Gary A. Tuma, MD, FACS
Princeton Plastic Surgeon

Unhappy with midface lift result

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I am sorry you are unhappy with your midface-lift result. I suggest -

  • if your face lift surgery is recent, it is usually best to wait 6 months
  • I will re-operate early at time, depending on the cause of the problem,
  • regardless, discuss the problem with your surgeon and have a plan for what to do, e.g. refining the scar, re-draping the skin.
  • if you have lost confidence in your surgeon, get several opinions from different Board Certified Plastic Surgeons until you find one you trust.
  • Minor problems may be corrected in the office. A major skin re-draping is done in the operating room usually. Hope this helps!
  • At times, with my patients I re-operate early if I think I can fix a troublesome problem. 


Facelift Correction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

    Skin draping problems can be corrected by elevating the skin flaps and redraping the skin in different vectors.  The key to the result is finding someone comfortable with fixing anything.  Find the board certified plastic surgeon with the best credentials to help in this case.

Can the transition lines from a mid facelift be corrected?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

 Not sure what would cause transition lines?  If by that you mean "pleats" then this is due to the direction of skin pull and a relative mismatch between the size of the skin flap and the incision line.  This can be corrected but would require re-opening the skin incision and doing whatever is required in the tissues below in order to free up the skin flap such that it can be re-draped without pleating.  

 This should not be considered, IMVHO, until at least 6 months following the previous Face Lift in order to ensure adequate blood supply to the skin has been established.  This could most likely be done using a minimally invasive Face Lift like our "Palmer Celebrity Face Lift".  

Need to have some idea as to how long ago and pictures would help

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The appearance you may have is not infrequent early after lifts.  Seldom do both sides appear the same early after surgery. This usually will correct with time. If you are within six weeks of your lift, I would still anticipate substancial adjustment in the tissues with more time.  Dr. Mayl Fort Lauderdale

Nathan Mayl, MD (retired)
Fort Lauderdale Plastic Surgeon

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.