A successful facelift surgery result not only looks more youthful and refreshed. An equally important goal is to create a natural-looking visage, with no telltale signs of the said procedure, as suggested by Los Angeles plastic surgery expert Dr. Tarick Smaili.
Simply put, the result of facelift should not “scream” plastic surgery.
Dr. Smaili explains the four most common telltale signs of facelift surgery and the “principles” he uses to avoid them.
1. Weird-looking ears. Most facelift techniques involve an incision that runs around the ear, particularly within the natural folds of skin to hide the scars. This will allow the surgeon to remove some excess skin, tighten the deeper facial tissue, and pull the skin to reduce the saggy appearance.
However, excessive tension on the skin and incorrect direction of pull could lead to pixie ear deformity in which it appears too elongated. Raisin-like wrinkles in the earlobe, meanwhile, are often caused by poor wound closure.
Avoiding excessive skin tension and incorrect wound closure can prevent wrinkly or elongated earlobes. For this reason, it is crucial to reshape the deeper structures of the face so the new contour will have a stronger support, with no or very minimal strain on the superficial layer.
2. Weird facial expression. The late Joan Rivers has been the poster child of botched facelift surgery because of her perennially surprised visage.
A “surprised” and “windswept” appearance is often caused by incorrect direction of pull and/or excessive tension on the skin. To avoid this look, the leading Los Angeles plastic surgery expert advocates the use of three-dimensional facelift approach in which fat grafting or dermal filler injection is used to create a more natural visage.
The idea is to restore the facial volume and rely less on skin pulling, which if done aggressively can backfire, Dr. Smaili warns.
3. Poorly placed scars. Facelift scars are positioned behind the hairline and around the ears to hide them. However, problems can arise when they migrate due to excessive skin tension, or thicken due to incorrect wound closure or because of the patient’s susceptibility to keloids.
Aside from minimizing skin tension during surgery, Dr. Smaili says proper wound care also plays a crucial role. The idea is to avoid infection, pressure, and other factors known to inhibit healing and lead to aggressive scarring.
But if the facelift scars remain persistent, Dr. Smaili recommends steroid injections, laser treatments, silicone tapes, or scar revision surgery.
4. Hair loss. Incisions are typically positioned behind the hairline so the scars remain hidden. However, incorrect or aggressive wound closure and failure to elevate the facial skin could lead to hair loss and unnatural hairline.
To avoid the aforementioned problems, the hair follicles and the surrounding blood supply should not be exposed to excessive trauma at the time of surgery.