Plastic Surgeon Dr. Dean Kane of Baltimore Answers Question Regarding Facelift Scarring
Q. With regards to incision by the ear – I know there has to be a scar in front of the lobe but have seen scars that extend in a little line in front of the ear where skin connects to cheek and then other scars that go inside the ear and come out by the lobe. I would like the second one but not sure why all surgeons don’t do this one as it is less obvious? Does it compromise the overall result? A. Thanks for this question. As you point out, each surgeon is as unique in his background, training, skill, talent and aesthetic understanding as his patients. For you, this small technique is important to you and should be discussed. There are many “nuances” to face and neck lift. The educated patient will learn through reading and consultation what is best and recommended for them. For my patients, I use a “tragal” or hidden-inside-the-ear incision to maximally hide any telltale signs of surgery. In men who may therefore have cheek hair carried onto the ear, options including removal of the hair shaft from the dermis at surgery and laser hair reduction are employed. Other incision techniques to consider:- Temporal incision versus side-burn incision?
- Straight, hair shaft -angled and/ or W- sideburn incision?
- External sutures, staples or only internal sutures and skin glue?
- Amount of skin elevation.
- Upward or lateral skin redraping?
- Pixie or hanging earlobe?
- Placement of posterior ear incision and hair loss.
- Permanent or dissolving sutures?
- Type of SMAS lift / suspension.
- Platysmaplasty, neck suspension suture or both?