COSMETIC TOWN JOURNAL



Expert Doctor

Short Scar Face Lift

Mike Nayak, MD

Saint Louis, MO

Short Scar Face Lift

A short-scar face lift is defined by the incision line being shorter than a regular face lift. Short-scar face lift is predominantly a marketing term trying to make it sound like the procedure is less invasive in some ways.

When people say a short-scar face lift, they generally mean the incision is limited from underneath the sideburns (in front of the ear), to underneath the ears, and around the back of the earlobe.

Some people describe short-scar face lift as an incision that starts with the earlobe, goes behind the ear and then down in the backside of the hairline. Others describe it as using both of those in combination from the sideburn hair to all the way around the ear and then back into the scalp hair.

There is not a standard definition for the procedure. The closest one would be the front half incision only which goes from the temple hair to around the front of the ear and stops behind the earlobe. With almost any surgeon in general, the short-scar face lift will have a shorter scar than the long-scar face lift or regular face lift.

The phrase short-scar face lift appeals to a lot of people who do not want a full face lift because it implies a shorter recovery time as well as being less invasive and less risky. Those things may or may not be true.

 

SKIN QUALITY

If there is such a thing as a short-scar face lift, why would anyone have a long-scar face lift performed? Why would a surgeon make the bigger incision and then have to fix it all and hope it heals well?

The biggest reason a person cannot have a short-scar face lift is because their skin is particularly loose. The general public and some surgeons have a perception that a face lift is for tightening the skin. That is modestly true, but with a face lift the skin is just a wrapper on the shapes underneath. Doctors lift away the facial skin and then remodel or reshape muscle the “facial clay” (muscle and fat that are creating the actual shape of the face). They shape the internal structures back into a younger shape and then put the skin back down. The excess skin does get trimmed, but the skin also has to drape well in order to look good.

Loose and sun-damaged skin has to be draped in a different way than younger-acting skin. The younger-acting skin can be draped with the incision lines kept shorter without the results wrinkling or being bunched up. Older, loose, more sun-damaged skin has to be draped in other ways that require the incision line to be lengthened.

Even though dramatic changes can be made with a short-scar or long-scar face lift, if the skin is loose and has poor quality, the patient is going to end up with a longer scar face lift. If the skin is springier and a better quality, a doctor can usually perform a short-scar face lift. It is a case-by-case basis with patients. The quality of the skin is one of the main limitations in doing a short-scar face lift.

 

COMPLICATIONS

The complications from a short-scar face lift are basically the same as a regular face lift. When doing a face lift, the skin layers are being worked on. With both the short-scar and the long-scar, the incision line itself is almost never a problem, but it might not heal as pretty as desired.

Anytime an incision is made, there is a risk of bleeding or an infection whether it is a short or long incision. If the doctor is only making half the incision, it is not lifting up quite as much skin so there is a little less area for fluid to accumulate later. Although they both have the risk of bleeding under the skin, the short incision has a little bit less of a complication than the other.

When it comes to infections, bigger incisions have a greater opportunity for bacteria to get in the incision. Keeping the incision shorter just means there is less risk.

There are other layers underneath the skin such as fat and muscle. There are also nerves that run within that fat and muscle. Whether it is a short-scar lift or a long-scar lift, those nerves can get irritated or injured and have either weakness or numbness. This risk is super low for both short-scar and long-scar lift however it is still a risk, and is almost always temporary.

 

CONVERTING FROM A SHORT SCAR TO A LONG SCAR

Occasionally, it is necessary to convert during surgery from a short scar to a long scar. The best case scenario is starting with a short incision line, and then, if the skin drapes properly, being able to stay with the short incision line. On the other hand, if after making all the changes on the inside the skin does not drape well, the incision line can be extended in these cases. It can be extended towards the longer side only as much as needed to get the skin to drape appropriately.

 

RECOVERY

The things that impact recovery the most are how far under the skin and how far forward under the skin the doctor worked. The longer the travel under the skin, the more bruising and swelling there will be during the recovery. What impacts the recovery the most is not the length of the incision line, but rather how much work was done under the skin.

With a short-scar the surgeon can be thorough and do a lot under the skin, but it is more difficult than working with a longer scar. The surgeon is working through a smaller opening while still trying to get everything done.

The recovery period is one to three weeks depending on how much is happening and how old the patient is. A patient in her 40s that is in good health and does not need a lot of real restoration will take about a week before feeling socially presentable.

Someone that is older and having a real reformatting of their face needs a lot more time to get over this procedure. They often need more involved surgery because they have advanced aging changes. Someone like that might need three weeks before they are socially presentable again.

 

RESULTS

The results are noticeable at one to three weeks. The final results are visible at three to four months with short and long scar face lifts. It takes three or four months because the tissues have to go through a healing process that remodels the tissues. After three to four months, most of the swelling is gone.

There are three ways to answer how long the results last, depending on one’s perspective:

1. A person could say the results last “forever” - because they will always look better as they age than if they never had the surgery.

2. A person could say the results last “several months” - because several months after the surgery, the patient will start noticing changes. They might feel like they do not look quite as good as they did when they first healed.

3. It could also be said that the results last 7 to 10 years because that is when the average person thinks about doing another procedure to improve upon where they are at that time.

 

FINAL THOUGHTS

A short-scar face lift is a face lift where the incision is shorter than a regular face lift. The incision goes from under the sideburns in front of the ear and then runs underneath to the back of the earlobe. While a face lift with a short scar might sound less invasive, but the best person to determine that is a surgeon. Patients should consult with a board-certified facial plastic, plastic, or cosmetic surgeon in order to determine if they are better suited for a short-scar fact lift or a face lift which results in a longer scar.

 

Written by Cosmetic Town Editorial Team- MA

Based on an exclusive interview with L. Mike Nayak, MD in Saint Louis, Missouri