Facelift surgery is not just about tightening the skin and deeper facial structure to rejuvenate one’s appearance. An equally important goal is to eliminate or at least hide any telltale sign of the procedure through proper scar placement, correct direction of pull, adjunct procedures, etc.
Facelift generally uses incisions behind the hairline that may extend in front, behind, or around the ear, specifically within the natural skin creases to hide the scars.
Around the incisions, temporary hair loss/fall may occur as the hair follicles go into a hibernation phase. For the vast majority of patients this will resolve on its own, although they could “accelerate” the healing process by using topical treatment such as Rogaine.
The general rule of thumb is to wait three months to see if there is any hair regrowth around the facelift scars.
Nonetheless, permanent bald patches do occur after a facelift procedure, particularly if there is an excessive damage to the hair follicles or due to incorrect wound closure. To prevent this complication, the general rule of thumb is to eliminate tension on the wound.
A technique called trichophytic closure is particularly helpful in preventing hair loss or bald patches following a facelift procedure. It involves suturing the overlapping edges of the wound, and removing a small piece of skin at an oblique angle (on one side of the wound), before the adjacent flaps are brought together to close the incisions.
With this wound closure, a piece of scalp tissue lies beneath the other, allowing the hair follicles from both flaps to grow and conceal the facelift scars. This technique is also helpful in hair transplant surgery.
To further eliminate any telltale sign of facelift, such as frontal hairline distortion or weird-looking sideburns, the direction and amount of pull should also be taken into account. The idea is to eliminate or at least minimize tension on the skin by contouring the SMAS (deeper facial structures) and not just the skin alone.
Should permanent bald patches occur after facelift, hair transplant surgery is the only permanent solution. This involves collecting hair follicles from the back of the scalp, grouping them together, and implanting them into the area that requires some coverage.
Most Los Angeles plastic surgery experts suggest waiting at least a year before considering hair transplant since hair regrowth is possible with time, or the patient could find hairstyle options that may hide their small bald spots.