How Can The Bad Scars From My Prior Facelift Be Improved.

Q: Dr. Eppley, How can the scars from may facelift be improved?

A: Thank you for sending your pictures. Your facelift scarring shows multiple issues which includes:

1) hypertrophic anterior scarring

2) trapped right earlobe skin

3) left pixie ear (pulled down scarring

4) bilateral anterior displaced preauricular scars

Like all secondary problems it is helpful to know exactly how the issues occurred so they could be avoided the next time. While you nor I will never know the exact details of your facelift (what was done under the hood so to speak), and I wouldlike to read the operative note from the surgery, I do know the following:

1) To be successful with the anterior (preauricular) scarring the facelift flaps must be re-raised ad the closure line moved back into a retotragal position which is more consistent with a female facelift. This will also hide some of the closure and give the rest of the anterior scarring a chance to heal better.

2) The elongated left earlobe is a form of pixie ear in which the scar pulls down on the earlobe, lengthens it and then shows visible scsarring below the earlobe. This again supports re-raising the facelift flaps.

3) For whatever reason there appears to be trapped earlobe skin/tissue in the closure line, hence the hole.

When you put all this together the only successful strategy is to redo the facelift…this time with deeper tissue support and different scar placement. (retrotragal) Management of facelift scars rarely is as simple as just cutting out the scars and closing. It almost always requires some or all re-elevation of the facelift flaps and a deeper method tio better distribute the forces onj the incisional closure. This becomes paramount because the ‘easy’ tissue laxity has been removed and now the tissues are scarred and less mobile.

Dr. Barry Eppley

World-Renowned Plastic Surgeon