Best Treatment for Scars After Face Lift

I had a face lift 8 months ago and have developed some scar tissue around my ears at the bottom of the earlobe. I have had 4 cortizone shots to try and reduce/flatten this area and it has only helped a little. I have also tried silicone sheeting and several scar therapy creams with no success. What are my options at this time? Is additional surgery my only option? Where I have developed the scars is very sore and tender.

Doctor Answers 14

Best treatment for scars after facelift?

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Hello! Thank you for the question! It is common for scars to fully mature for up to a year. In the meantime, there are a few things that may help to ameliorate your incision/scar. The most proven (as well as cheapest) modality is simple scar massage. Applying pressure and massaging the well-healed scar has been shown to improve the appearance as it breaks up the scar tissue, hopefully producing the finest scar as possible. Other things that have been shown to add some benefit, albeit controversial, are silicone sheets, hydration, and topical steroids. In addition, avoidance of direct sunlight to the incision will significantly help the appearance as they tend to discolor with UV light during the healing process.

If unsightly scars are still present after approximately a year's time, other things that your surgeon may consider are intralesional steroid injections, laser, or just surgical revision of the scar itself.

Hope that this helps! Best wishes!

Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

Managing Scars Following Your Facelift

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The #scars from a facelift mature within six to twelve months from the surgery date. It is during this time that the rejuvenating effects of the facelift will become apparent and the real result will be seen. We find that scar reducing product, BioCorneum , appears to be very effective. 

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.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Facelift scars - how to treat

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All scars go through three phases of healing with an initial redness phase followed later on by rebuilding and maturation of the scar.  Most scar and wound experts agree it takes about a year for a scar to fully mature.   Facelfit scars are commonly seen as red and can be hypertrophic.  Treatment of scars depends on the type of scars seen and can include the following treatments: -laser treatments to help both scars and redness of scars  -injections of kenalog or a combination of kenalog and 5-FU  -scar revision if poorly positioned scar The key to great scars after a facelift is to avoid tension on the skin and lift the deeper layer of the face.  Placing too much tension on the skin can make scars wider than ideal.  Meticulous closure technique can also aid in scar appearance.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 177 reviews

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.

Face lift scars at 8 months

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As long as there is enough laxity it is probably best to remove the old scars and take a number of steps to make sure the new scars heal better:

  • Having minimal tension on the wound
  • Using minimal dissolving sutures
  • Using topical silicone gel and tape on new scars
  • Injecting the scar at the earliest sign of thickening

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Hyperthrophic Scars are what you have.

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This does happen with face lifts.  You describe hypertrophic scars and not Keloid scars.  You have done everything right.  The scars are active which is why they are sore and tender.  Re-excision is best.  Steroids can be injected in one week or at the time.  The most important thing is that the scars will now not be closed under tension.

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 81 reviews

Non ablative 1540 laser may be best treatment for facelift scars

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Raised red scars after facelift are typically Hypertrophic Scars caused by the tension on the scar produced by the skin that has been tightened.

In my experience treatment of reddened rasised scars after facelift can be helped by treating the facelift scar with Non-ablative fractional 1540 Erbium Laser treatments. Usually 3 or 4 treatments are required to lessen the redness and reduce the bulk and size of the scar. I use the Lux1540 laser and have been happy with the results. The benefit of the laser is that unlike steroid injection, there is no risk of tissue atrophy or production of visible red blood vessels in the treated area.

Eventually after the scars have matured it may be necessary to surgically revise the scar-this can usually be done under local anesthesia and can be used as an opportunity for further tightening of the facial skin

I am somewhat surprised that Steroid injections and Silicone Sheeting did not help lessen your facelift scars. Have you asked your doctor if the scars are true Keloid Scars-if so excision of the keloid and post excision radiotherapy may be required

Facelift scars

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This is a tough problem.  If there is some reason for the poor scarring - delayed healing, too much tension, wound infection, spitting stitches, etc - then a revision is very reasonable assuming the aforementioned issues could be avoided.  But if everything went very well early post-op, you just may be one of those people who scars badly and revision may not help.  Discuss this with your surgeon and it may even make some sense to get a second opinion.  Also, easy does it on the steroid injections.  They can cause atrophy of the fat and widening of the scar.

Good luck.

Lisa Lynn Sowder, M.D.

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 77 reviews

Scars after a facelift

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Short of surgery, the only other thing you might consider is a custom made compression garment using the silicone sheeting beneath this.  Although it would be ideal to wear the garment 24/7, you may try to at least wear it at home and during the night.  Compression with silicone sheeting has helped more than either modality alone.  Otherwise, scar revision when the tissues are more pliable may be the only other option.

Theodore Katz, MD, FACS
Philadelphia Plastic Surgeon

Best Treatment for Scars After Face Lift

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Thank you for your question. Scars will improve over time over a two year period. Follow the advise of your surgeon. Laser resurfacing, silicone products, and massage will help scars improve.  Unfavorable scars can be revised after a year. Best Wishes.

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.