Facelift scars are well concealed behind the hairline, around the ear’s contour, and within the natural folds of skin. Nevertheless, proper wound closure in which there is little or no tension on the skin is important to prevent scar migration, which is one of the most common concerns of patients.
Beverly Hills plastic surgeon Dr. Karan Dhir says scars tend to fade quicker and better in older patients whose skin is more lax than younger individuals who typically wait 18-24 months for their scars to settle and “mature.”
Most of the healing takes place within two months, although Dr. Dhir advises patients to wait up to a year before they “judge” their scars, especially if they are considering a scar revision surgery.
In the first few days, the wound goes to an inflammatory stage in which it appears swollen and red and is susceptible to infection, although the risk can be minimized by good hygiene, wound care, and possibly use of antibiotics.
The second stage, meanwhile, happens three to four weeks postop in which fibroblasts or cells responsible for forming new skin and other tissue are produced in abundance. At the same time, the injured skin releases collagen to close the wound together and release tiny blood vessels needed for healing.
The fibroblast stage is believed to be a crucial time since scar tissue caused by “faulty” collagen may develop, leading to keloids or hypertrophic scars that appear thick, raised, and discolored.
At this stage, it is not uncommon for doctors to require their patients to use silicone sheets or tapes for as long as tolerated. Proponents suggest that these treatments provide constant pressure that prevents scar tissue or “haphazard” collagen from forming within the dermis.
And because the silicone sheets create a moist environment, they also encourage the scar to heal and fade quicker.
Aside from the use of scar treatments, Dr. Dhir says good nutrition and health plays a crucial role in “favorable” scarring, i.e., fine lines that blend well with the skin and/or behind the scalp. The general rule of thumb, he adds, is to increase protein intake weeks prior to facelift and during recovery as well.
Avoiding smoking at least three weeks before and after facelift also prevents “unnecessary” or “aggressive” scars. Dr. Dhir warns that all tobacco and smoking cessation products contain nicotine, which is known to constrict blood vessels and lead to compromised healing.