Why is it that the shape of the skin (tragus?) that connects to the ear looks different after a facelift?

Dr. Dean Kane Q & A.shutterstock_85596703 Q. For me that is the telltale sign of work having been done. I have noticed that even Kris Jenner (who I imagine has access to the best of the best in Surgeons) of the infamous Kardashian family has her hair cut and styled to hide that part of her ear. A. ​Surgical facelifts would be likened to pulling the bedspread and / or top-sheet of your bed up to the head-board and removing the excess material. If the skin is advanced too tight, the skin will ripple or create a wash-board and pull-back from where it was stretched. The visible scar and the under-the-skin scar heal tighter creating a over-done, “wind-swept” or “pulled” appearance. The result of this is:
  • ​A wider scar
  • ​Poorer healing due to tension and possible the incision opening
  • ​Pulling or shifting of the cartilaginous tragus forward
  • ​Pulling of the earlobe and scar insertion creating a “pixie” effect
  • Lifting of the temple hairline, losing the sideburn
  • And / or adding too much tension on the upper neck hairline creating the telltale wide, red scar.
In decades past, the skin was pulled taught with less lift on the underlying soft tissues. Current best techniques will use the SMAS or fascial layer under the skin to lift and re-suspend the sagging soft tissues of the fat and muscle system underneath without pulling on the skin. The more carefully hidden curved incisions and widely undermined skin will be redraped over the tighter, lifted quilting of the soft tissues underneath provide a softer and more natural tucked-in appearance. In this way, the skin is minimally stretched caringly without tension and obviating the pulled, wind-swept and odder looks of yesteryear. ​ ​Thank you for this question as it provide a better insight for the public as to the incision sites and facelifting techniques the surgeon selects for each individual patient. Choose a well experienced, Board Certified Plastic Surgeon or ENT Facial Surgeon in consultation and surgery.
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