Q: I had a facelift last year but am unhappy with some ‘dogears’ in my scar under my chin. Can this be improved by extending the scar?
A: Most full or more complete facelifts involve an incision under the chin. (submental incision) This is done to access the central neck area for fat removal and neck muscle tightening. Usually this is a very small incision and does not involve the removal of skin. It is simply a point of access. It is closed and there is very rarely any scar issues with it. Dog ears, a redundancy or bunching of skin at the ends of a scar, do not usually occur with this submental incision as no skin is removed. In short, this inicision is not there to do some sort of ‘neck tuck-up’.
There is a neck procedure done known as a submental tuck-up which is done for chin ptosis or sagging. But this is not done to create a neck lift. That is a fundamentally flawed approach as the neck can not really be lifted by this limited incision. To do so would require a much longer incision which would usually be cosmetically unacceptable. I have seen a few patients over the years who have had this type of procedure done elsewhere and the results have not been good for this very reason. You can not lift and remove enough neck skin with a cosmetically acceptable submental incision.
If you have dogears in your submental scar, I am wondering if this might be the operation that you had. The dogears can be removed but it will require extending the scar length as you have surmised.
Dr. Barry Eppley