Case Number: 207
- Before After
The follow up photo is approximately 1 month after the operation
Procedure: Laser Peel, Blephlaroplasty, Face Lift
A QUICK NOTE ABOUT SCARS
One of the artistically important features of face-lifts is placing the incision in just the right area. Our face-lifts follow the natural creases in front of the ear and behind the ear in order to produce the least possible chance of significant scarring. We follow the area from the hairline down in front of the ear in the crease between the upper part of the ear and the skin of the face. This is sewn very carefully in order to conceal this scar in the fold. Then, we go behind the little bump in the middle-front part of the ear so this scar is usually completely concealed. One of the very important parts of performing a proper face-lift is making this area as loose as possible so the little bump does not get pulled forward toward the middle of the face in an unnatural fashion, a frequent problem with a beginner's face-lift. Then, the scar goes around the ear lobe right in the crease and up the back of the ear in the crease. The scar goes into the hairline behind the ear. Dr. Yoho makes a special effort to put this part of the scar very, very high--almost at the top of the ear in order to conceal it properly. Most textbooks recommend putting the hairline scar at the external ear opening. This is too low. If there is a scar behind the ear with Dr. Yoho's face-lifts, it is generally so high that women can wear their hair up and the scar is not seen.
One of the frequent problems with face-lift scars is the "pixie earlobe". This consists of an earlobe which is pulled downward in an unnatural fashion. The reason for this is a surgeon who trims the skin below the ear lobe in a very aggressive fashion and sews it up to the ear lobe. Skin that is sewn into the ear lobe like this will eventually shrink and pulled the ear lobe down, making a sort of Start Trek or Dr. Spock ear, which is very unattractive and a good indication of an amateur face-lift.
If you have had a face-lift and your scars are a long ways from being in the creases of the ear and can be seen all the way around the ear, we can sometimes improve things with dermabrasion, which will blend the scars and help conceal them by injuring the surface of the skin and allowing normal skin go grow over the scar. This works best in the first 6 weeks after the original procedure. If this doesn't work, a secondary face-lift may be necessary. In many cases, a secondary face-lift can completely correct visible scarring, because the scars can be pulled up and concealed where they should have been placed originally.
One of the other problems with face-lift incisions is elevation of the hair right in front of the ear. One alternative is to put a scar at the bottom of this hair tuft, but Dr. Yoho feels in most cases this is not necessary and that the pull on the skin in this area is better if it is not straight up. It should rather be up at a 45-degree angle. This will prevent elevation of this little patch of hair so the results are natural, without a strange looking high hairline.
Be sure and discuss these issues at your consultation with your surgeon.
This lady was from the Los Angeles area and was operated on in our Pasadena surgical facility.