What is normal scarring after a facelift? | James H Rosing, M.D.

Patient Question: What is a normal amount of scarring after a facelift? How long should it take to heal? Are lumpy scars behind the ear lobe normal? Should you be able to feel a raised scar in front of your ears? How do you approach your surgeon with concerns about scars?  

Dr. Rosing:  It is difficult to define a normal amount of scarring after a facelift as people heal differently.  It is typical for the preauricular (in front of the ear) scar to heal smoothly as a thin line that changes color from deep red to pink and then tan or slightly lighter than the surrounding skin.  I agree with the other surgeons above who answered regarding the postauricular scars occasionally being bumpy or irregular.  These will flatten-out and soften with time.  Time being 6-8 months.  Hypertrophic scarring is rare in front of the ear, though can occasionally happen behind the ear.  Keloid scarring is when the thickened, raised scar extends beyond the area of the incision.  Keloid scarring has a genetic component and is less common than hypertrophic scarring.

 

With regards to a mini-lift, it is hard to know if there is an increased or decreased risk of abnormal scarring as it would be related, at least in part, to the amount of tension on the skin.  The amount of tension on the incision line is directly proportional to the risk of developing a hypertrophic scar.  If by mini-lift, you mean a skin only lift, then perhaps there is slightly more risk of hypertrophic scarring than in a SMAS or full lift where the underlying muscle is tightened as well as the skin.

 

Steroid injection and fractional laser treatment can help soften thick scars as well as improve the aesthetic outcome.