Where Are Incisions Made?
Reality check – there is no such thing as a facelift without incisions. To recontour and reposition structures in the face that have sagged and drooped, we have to make incisions in the skin. While I perform the latest techniques, including minimal incision facelifts, your particular anatomy and desires determine what has to be done – and what has to be done always involves some skin incisions. The goal is to make those incisions invisible to both you and your friends and loved ones (as well as those jealous people you also know!!!)
During facelift procedures, incisions are typically made in well-hidden locations. In most cases, I will create an incision along the base of the sideburn, beveled so that when your hair grows it will grow through the incision and conceal it. I then move just in front of the ear, in the natural crease and shadow line where the upper ear touches the cheek. I continue in that crease line to the tragus – the little flap of skin and cartilage that covers the ear canal. At that point, I go inside the ear, then just in front of the earlobe where it connects to the cheek. I then turn around and under the earlobe into the crease in the back of behind the ear up to the hair then either into the hair-bearing scalp or along the hairline behind your ear. The purpose of hugging the ear so closely is to take advantage of natural shadows and creases. That way, any residual scar that is seen will appear to be a crease line, not a scar!
When a neck lift is performed with the facelift, a small incision is made under the chin – this generally appears as a natural skin crease. No additional skin incisions are necessary for the neck lift.
Concealing the incisions in shadow and crease lines is the first step. Gentle handling of the skin during surgery is critical, and obsessive attention to suturing technique is also necessary to make your incisions virtually invisible. Skin staples, which were developed in the 1970s, are a quick way to close skin incisions but are not a substitute for artistic suturing using sutures that are often thinner than a human hair. I never ever use staples to close the skin… and I never will!
When done correctly by a skilled surgeon, facelift scars are almost non-existent. I work in such a way as to meticulously open and close my incisions to minimize tissue disruption. This specialized technique ensures an optimal outcome with minimal swelling, bruising, post-surgical bleeding, or scars.