Am I a candidate for a facelift after radiation therapy to head & neck 2016? (Photos)

Question

I underwent radiation therapy to the head and neck in 2016. As a result, the right side of my face, from the jawline up, shows prominent vein protrusion and is unsightly. If I pull the skin back to my ear it makes a big improvement, essentially hiding the veins. Am I a candidate for this type of procedure given my history. My neck is significantly fibrotic but I'm hoping it won't be an issue.

Ronald J. Edelson, MD · Answer

It’s a great question. The issue with radiation is one of blood supply and healing. Radiation makes healing a facelift more risky although it varies from patient to patient. In your case the area directly around the ear looks ok. So a very conservative lift as you demonstrate may be feasible

Zoran Potparic, MD · Answer

Every irradiation causes significant damage to skin blood supply regardless of the area. For that reason a procedure that relies on significantly limited blood supply like face lift, is expected to undergo more necrosis than non-irradiated skin. In your case it may be wise to consider micro and nano fat grafting several months before considering face lift. It may improve circulation, decrease  fibrosis and improve discoloration of the skin. When conditions are improved a conservative face lift may be considered. Hope this helps.

Mats Hagstrom, MD (license on probation) · Answer

Radiated tissue behaves very differently than tissue that has not had radiation therapy.
I would not recommend doing cosmetic surgery on that side. Any attempt at improving the contour would be extremely complex and requires bringing in non-radiated tissue from other sources, such as the use of free flap surgery.
Putting tension on radiated tissue and expecting it to close can lead to disastrous outcomes with wound failure that can persist indefinitely.
Any plastic surgeon who’s had experience working on radiated tissues? Should have the same degree of caution. Working with fillers is probably the safest and most appropriate approach. Using very dilute, fillers to restore the lost volume from radiation induced fat atrophy may be helpful. Fat grafting is unlikely to be successful.
Radiated tissues are highly unpredictable and tend to not heal in reliable manners. You should be very careful with anyone enthusiastic about doing cosmetic surgery on this side and always verify with a second opinion.
Best,
Mats Hagstrom, MD

Am I a candidate for a facelift after radiation therapy to head & neck 2016? (Photos)

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