Dr. Calabria Explains What Causes Facelift Scars

Good morning. The topic of the day is facelift scars. I noticed there is a lot of misinformation about facelift scars, so I want to give you the essential information that you need, so you can be prepared if you’re considering a facelift and afterwards, you know what to do if the scars don’t satisfy you a hundred percent.

Of course, facelift scars are very important and are a crucial part of the success of the facelift. We try to place scars strategically in key positions so they’re less visible. Again, the goal at the end of the day is to make it as undetectable as possible. Scars in the facelift are placed in different positions according to the technique of the surgeons, but, overall it is also important not to compromise the final result in order to deliver fine scars. It’s always a compromise between a fantastic result with the scar that is less visible as possible.

Again, what are the factors that cause bad scarring? People, patients, think it’s just a worse technique, it’s the plastic surgeon’s fault, and, sometimes, it is true. But there are three factors that contribute to bad scarring, and these are: number one, your genetic background. The genetic background will also dictate how well you’re going to scar. If you have a tendency of hypertrophic or keloid scars, you’re at higher risk of developing a bad scar when doing a facelift. Darker-colored people have worse scars than a lighter-texture patient. You have to be aware that if you are African-American, Asian, Middle Eastern, you may have a tendency to scar worse than a Caucasian patient.

Now, the second most important factor is technique. Of course, there are different techniques that we use. I definitely try to minimize the scars by using a stitching that will not leave any stitch marks. I take my time to close the incision. Some plastic surgeons will delegate that to their assistants. They do more than one case a day. My philosophy is one case a day. You’re the case of the day. I do from the first stitch to the last stitch because you deserve the best. Again, that’s very important. I’m Italian. I call it a very Italian designer facelift, so it has to be stitched to perfection.

But the third and most important cause of bad scarring is tension on the scars. Now, the tension will have the scar spread a little bit. But, remember, you need tension on the facelift flap in order to make it long lasting and to deliver a good result. Of course, my main concern is that the facelift will be long lasting. You’re devoting a lot of time and you’re spending a lot of money on facelift surgery. If it doesn’t last more than a year or two, you wouldn’t be.

So my question to you is, would you rather have to revise a facelift because the doctor didn’t put enough tension and the skin has relaxed or to revise a little scar because the tension has caused the spreading?

The revision of the scar, it’s very easy. It’s done under local anesthesia. It takes a few minutes. The timing of revision is very important though. It needs to be done in a timely fashion. You do it too early, there is still tension on the scar and the scar will spread again. We need to do it at least six months, if not a year, after the original surgery in order to deliver the best result.

My scar revision rate is very low. It’s, I would say in 1 or 2% of cases. But I always tell patients, “Look, I am here for you. If, by any chance, the scar does not satisfy you, and to be honest, I’m very picky. If I see a scar that doesn’t look good, I’m the first one who wants to revise it because my signature is on your face.”

Scar revision is very easy. It needs to be done at an appropriate time. But at the end of the day, it’s a lot easier to revise a scar under local anesthesia than to have to redo the full facelift because the surgeon has not put enough tension on the flap and the skin is sagging again, especially in the neck.

Again, there are techniques that I use in order to minimize the tension, the VIP closure, look it up on my website or on Instagram, and special technique by pulling the muscle first and the skin later. Techniques in which I place the scar inside the ear cartilage, not in front. That experience and that is what a good plastic surgeon is all about. But again, focus also on the natural result of the face, how long it will last. The scars are important, but again, they’re easy to revise if you have a predisposition of a scar or so on.

Of course, at the end of the day, you want to make sure you can wear your hair up. In guys, it’s very important to place the scar in a way it’s not visible. Again, that is really crucial, but again, it’s easier and the point that I’m trying to make here and leave you with this is it’s not always the plastic surgeon’s fault. If the scar doesn’t heal well, consider other factors and talk to your plastic surgeon. I’m always here for you. I want my main goal to be your satisfaction and I will not stop until you’re fully satisfied.

This is about facelift scars. It applies also to other scars, but it’s important because facelift scars are visible and you want to go out like you don’t show you that you had a facelift. Of course, another telltale sign is to pull horizontally, and you end up with what we call a windtunnel look, which is dreadful.

It’s a combination of things to deliver the best result. I do facelifts for a living, and I think I deliver an excellent result. Stay tuned for more information.