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Facelift Scars: How They Can be Minimized

How can I minimize the appearance of facelift scars?

A surgical facelift is a highly effective way to lift sagging cheeks and jowls to create a more
youthful appearance one of the most common concerns expressed during a
consultation when I discuss face lifts as part of a facial rejuvenation plan is
the potential visibility of the facelifts scar which is located at the
sides by the ears my approach to cosmetic procedures
whether it’s facelift eyelid rejuvenation and non-surgical procedures
such as injectables is to retain my patients unique facial character while
achieving a naturally refreshed look generally speaking the people who I care
for like looking like the best and natural versions of themselves at any
age I’ll share how I’m in amaizing appearance of facelift incisions in my
practice I’m Dr. Amiya Prasad I’m a Board-certified cosmetic surgeon and
Fellowship-trained oculofacial plastic and reconstructive surgeon I’ve been in
practice in New York City and Long Island for over 25 years I perform all
types of facelifts such as short scar mini lifts deep plane facelift and
extensive face and neck lifts I’m also called upon to help people who have
undesirable faces of scars from other doctors this is due in part to my having
developed my own adult stem cell based regenerative healing strategies for
tissue loss surgical incisions and scar revision there are several factors that
affect the appearance of facelift incisions these factors include the
placement of the incision the tension on the incision after
closure and the way the tissue heals over the next several months after
surgery I cannot stress enough some basic strategies which I employ that I
believe are critical to optimal results for any surgery for example in my
practice I spend a lot of time with my patients in my exam room with them
sitting up the for surgery so I can place my markings for the incisions
strategically I examine my patients face and neck skin and soft-tissue to
determine the optimal direction of elevation and to determine the potential
level of tension there will be after the skin is trimmed and the sutures are
placed this is a critical part of the artistry and for me to visualize the
results I expect to achieve since I have my own facilities i allocate and factor
in additional time to allow me to never be rushed during surgery this is
something that many of my patients understand that by investing their
resources and time and having this level of attention they able to get better
outcomes I’ve seen many patients who were operated on by high volume low cost
doctors who claim to be the number one plastic surgeon wherever they are this
type of doctor rushes through surgery to make up for the money they need to make
in order to charge such low prices and they end up doing unintentionally subpar
work I’ve also seen poor outcomes in patients of doctors who claim to be the
best and charge a lot but end up taking on too much work and the patients don’t
get the quality results they otherwise could have once again I decided to treat
each patient so that there’s no time pressure and I have my schedule managed
accordingly if you think about it like an athlete a surgeon has a timeframe of
peak performance in any given day as far as how placement of the face
that incisions affect visibility or the potential of a telltale sign of having
had surgery I factored in the skin texture the color and contrast with the
skin at the opening of the ear and the characteristics of the sideburn for a
more extensive face and neck lift where the incision goes around the earlobe and
extends upward behind the ear and back towards the hair I designed the
placement so if a woman wants to pull her hair back the incision will be well
hidden skin shortage and tension at the earlobe can result in downward
displacement to the earlobe which is referred to as a pixie ear deformity
when this occurs the earlobe appears attached and elongated
as opposed to detached and freely mobile I have helped people who have come to me
with this problem by detaching and redirecting the position of the earlobe
attachment I have seen many patients who’ve had wide scars in front of their
ears due to excess skin tension one reason for this is simply removing too
much skin and relying on the skin alone to lift the face this is not as
effective as lifting the underlying tissue called the SMAS or superficial
musculo aponeurotic system as the foundation for the skin to be supported
by poor artistry or execution of the skin trimming is another reason for
stretching of the scar by the ear as I stated earlier it takes time and
artistic vision to plan as well as surgical skill and experience to achieve
optimal results I feel that my experience allows me to better predict
the potential issues that can occur so I can take the appropriate steps to
optimize my patients healing is it possible for well performed surgery to
have issues with incision visibility related to how the skin heals afterwards
the answer is yes it’s possible I approach this part of the healing after
surgery by using advanced wound healing technology to expedite the processes
that occur during wound healing I use materials such as extracellular matrix
by a cell which has been used to regenerate a wide range of tissue in the
body for example extracellular matrix was used to regenerate an entire
fingertip including the fingernail and even the fingerprint after a traumatic
amputation injury I often combine extracellular matrix of platelet-rich
plasma or PRP which is derived from your own blood as a catalyst for this process
I have successfully used this strategy with facelift incisions which appear to
be virtually invisible in as little as one month after surgery aftercare by the
patient and close monitoring by myself and the staff is a very important part
of a strategy to achieve optimal results while not directly associated with
facelift scars I attribute part of the faster facelift recovery my patients
experienced by my performing the procedure using local anesthesia with
LITE IV sedation instead of general anesthesia general anesthesia requires
the patient to be paralyzed and the patient needs to be on a respirator in
order to breathe the face can be distorted by the presence of breathing
tubes and other medical apparatus needed when you have general anesthesia since I
use local anesthesia with Lite IV sedation the patient is comfortable and
in a twilight state of consciousness my patient’s face is in a more natural
state and I have the ability to be much more precise my patients go home the
same day a surgery without suffering the side-effects of general anesthesia or
needing to be in a facility for monitoring for
when face ups are performed with general anesthesia patients generally need to
stay in an overnight facility often with drains and extensive facial bandaging
the side effects of general anesthesia can linger for about a week and even
delay the progress of surgical recovery in contrast my patients undergoing the
procedure with local anesthesia typically only require a light facial
dressing and return to work in about a week
for example many years ago I actually performed upper and lower eyelid surgery
as well as a facelift for a lady who wanted to look good for her son’s
wedding which transpired 10 days later she did very well but I would recommend
a little more time before a significant event where you are getting a
significant amount of attention while no incision can be completely invisible a
face lift incision can be virtually imperceptible with a combination of
minimal tension optimal placement advanced healing and proper aftercare
your facelift results start with the judgement experience and expertise of
your surgeon I often perform face lifts with other rejuvenating procedures
including eyelid surgery and facial filler placement as I said earlier I
believe in taking a lot of time to plan and design each patient surgery before
they go into the operating room in the operating room I allocate extra time to
allow me to perform my patients procedure without any time related
pressures every step matters my strategy is also flexible and I make the
adjustments as the results of the procedure I’m performing materializing
meticulous suture placement is also critical for optimal healing which of
course takes time my patients understand the value of investing their resources
and time to have the level of care they need in order to get
the natural results that they want my patients are with me for the long term
and I continue to be their beauty doctor for injectables laser and skin
rejuvenation for years after I performed their facelift surgery
I believe that surgeons whose practices are geared toward volume cannot provide
quality because of limited time and being rushed and unable to focus this
statistically can lead to a higher rate of undesirable scars and other avoidable
complications I hope you found this information helpful thank you for your
question

A surgical facelift is a highly effective way to lift sagging cheeks and jowls to create a more youthful appearance. One of the most common concerns expressed during a consultation when I discuss facelift as part of a facial rejuvenation plan is the potential visibility of the facelift “scar” which is located on the side of the ear. My approach to cosmetic procedures, whether it’s a facelift, eyelid rejuvenation, or nonsurgical procedures such as injectables, is to retain my patient’s unique facial character while achieving a naturally refreshed look. Generally speaking, the people I care for like looking their best, natural versions of themselves at any age. I’ll share how I minimize the appearance of facelift incisions in my patients.

Facelift and neck lift Patient Before and After surgery - three-quarter view
before and after plastic surgery new york

I perform all types of facelifts, such as short scar mini lifts, deep plane facelifts, and extensive face and neck lifts. I’m also called upon to help people who have undesirable facelift scars from other doctors. This is due in part to the adult stem cell-based regenerative healing strategies for tissue loss, surgical incisions, and scar revision I developed for my patients.

Several factors affect the appearance of facelift incisions, including: the placement of the incision, the tension on the incision after closure, and the way the tissue heals over the next several months after surgery. I cannot stress enough some basic strategies, which I believe are critical to optimal results for any surgery. For example, I spend a lot of time with my patients in my exam room with them sitting up so I can place my markings for the incisions strategically. I examine my patient’s face and neck skin, and soft tissue to determine the optimal direction of elevation, and to determine the potential level of tension there will be after the skin is trimmed, and sutures are placed. This is a critical part of the artistry, and for me to visualize the results I expect to achieve.

Since I have my own facilities, I allocate and factor in extra time so that I am never rushed during surgery. This is something that many of my patients understand by investing their resources and time in having this level of attention.

I’ve seen many patients who were operated on by high-volume, low-cost doctors who claimed to be top plastic surgeons. This type of doctor rushes through surgery to make up for the money they need to make because they charge low prices.

Bad facelift scars

I’ve also seen poor outcomes in patients of doctors who claim to be the “best” and charge a lot, but end up taking on too much work and failing to deliver the quality results they could have done. Once again, I decide to treat each patient individually to avoid time constraints, and I have my schedule planned accordingly.

Facelift scar revision before and after
Facelift scar revision before and after procedure done by Dr. Prasad

When you think about it, a surgeon, like an athlete, has a time frame for peak performance on any given day. In terms of how the location of the facelift incision affects visibility or the possibility of a telltale sign of surgery, I consider the skin texture, color, and contrast with the skin at the opening of the ear, as well as the characteristics of the sideburns. For a more extensive face and neck lift where the incision goes around the earlobe and extends upward behind the ear and back toward the hair, I design the placement so if a woman wants to pull her hair back, the incision will be well-hidden.

pixie ear deformity before and after
pixie ear deformity facelift before and after

Skin shortage and tension at the earlobe can result in downward displacement of the earlobe, which is referred to as a pixie ear deformity. When this occurs, the earlobe appears attached and elongated as opposed to detached and freely mobile. I have helped people who’ve come to me with this problem by detaching and redirecting the position of the earlobe attachment.

I’ve seen many patients with wide scars in front of their ears as a result of excessive skin tension. One reason for this is that too much skin is removed, and the face is lifted solely by the skin. This is not as effective as lifting the underlying tissue called the SMAS or superficial musculoaponeurotic system as the foundation for the skin to be supported. Poor artistry or execution of the skin trimming is another reason for stretching the scar by the ear.

Short Scar Facelift patient Before and After results - three-quarter view
facelift and neck lift before and after

As I previously stated, planning takes time and artistic vision, as well as surgical skill and experience, to achieve optimal results. My experience enables me to better predict potential issues, and take appropriate steps to optimize my patients’ healing.

Is it possible for well-performed surgery to have issues with incision visibility related to how the skin heals afterward? The answer is yes, it’s possible. I approach this part of healing after surgery by using advanced wound healing technology to expedite the processes that occur during wound healing. I use materials like ACell’s extracellular matrix, which has been used to regenerate a variety of tissues in the body. For example, extracellular matrix was used to regenerate an entire fingertip, including the fingernail, and even the fingerprint after a traumatic amputation injury. I often combine the extracellular matrix with platelet-rich plasma, or PRP, which is derived from your blood as a catalyst for this process.

Facelift incision healing with ECM 1 month after surgery

I have successfully used this strategy with facelift incisions, which appear to be virtually invisible in as little as one month after surgery. Aftercare by the patient, and close monitoring by myself and the staff are very important parts of the strategy to achieve optimal results.
While not directly associated with facelift scars, I attribute part of the faster facelift recovery my patients experience to my performing the procedure using local anesthesia with LITE IV sedation instead of general anesthesia. General anesthesia requires the patient to be paralyzed, with a respirator needed to breathe. The face can be distorted by the presence of breathing tubes, and other medical apparatus needed with general anesthesia.

Dr. Prasad performs surgery using LITE anesthesia

Since I use local anesthesia, with LITE IV sedation, the patient is comfortable in a twilight state of consciousness, my patient’s face is in a more natural state, so I can be more precise. My patients go home the same day as surgery without suffering the side effects of general anesthesia, and needing to be in a facility for monitoring after recovery. When facelifts are performed with general anesthesia, patients generally need to stay in an overnight facility, often with drains, and extensive facial bandaging. The side effects of general anesthesia can linger for about a week, and delay the progress of surgical recovery.

before and 1 week after Short Scar Quick Recovery Facelift
facelift picture before and after 5 days Quick Recovery

In contrast, my patients undergoing the procedure with local anesthesia typically only require a light facial dressing, and return to work in about a week. Many years ago, I performed upper and lower eyelid surgery as well as a facelift for a lady who wanted to look good for her son’s wedding, which transpired 10 days later. She did very well, but I would recommend a little more time before a significant event where you are getting a significant amount of attention.

While no incision can be completely invisible, with minimal tension, optimal placement, advanced healing, and proper aftercare, a facelift incision can be virtually imperceptible. Your facelift results begin with your surgeon’s judgment, experience, and expertise.

Facelift Patient Before and After in three-quarter view
before and after facelift surgery on 50 yrs old female patient left quarter view

I often perform facelifts with other rejuvenating procedures like eyelid surgery, and facial filler placement.
As I said earlier, I believe in taking a lot of time to plan and design each patient’s surgery before they go into the operating room. In the operating room, I plan ahead of time so that I can perform my patient’s procedure without feeling rushed. Every step counts. My strategy is also adaptable, so I make fine adjustments based on the procedure’s outcomes. Meticulous suture placement is also essential for optimal healing, which, of course, takes time.

My patients understand the importance of investing their resources and time to receive the level of care required to achieve the natural results they desire.

deep plane facelift before and after recovery results - three-quarter view
deep plane facelift before and after - early 60s years old female - quarter view

My patients stay with me for a long time, so I am their beauty doctor for injectables, laser, and skin rejuvenation for years after I perform their facelift. I believe that surgeons whose practices are geared toward volume are unable to provide quality care due to time constraints, being rushed, and being unable to focus. This can lead to an increase in undesirable scars and other avoidable complications.

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