Facelift Problem Corrections

We have all seen “facelifts gone bad” on television. Fortunately these problems are rare. One of the biggest fears of prospective facelift patients is having an “operated,” “wind tunnel” or other unnatural look. Every facelift patient will say “I don’t want to look like Joan Rivers”.

Dr. Niamtu discusses how to avoid facelift complications in facelift surgery

Although the best doctors can have complications, most unnatural facelifts are usually the result of improper technique. When the proper procedure is performed on the proper patient an unnatural look is uncommon.

The following patients were NOT originally operated on by Dr. Niamtu but he fixed their problems.

Pixie Ear Lobes

Pixie Ear Lobe example (NOT done by Dr Niamtu)

The picture on the left shows a “Pixie Earlobe”. This is frequently from improper facelift technique and is unfortunately an all too common complication with some surgeons. This results from “hanging the cheek or neck skin on the earlobe”. This happens if too much tension is placed on the earlobe or from improper surgical planning.

This deformity can be corrected and the Pixie Ear Lobes pictures on the right show patients whose procedure was done elsewhere and was corrected by Dr. Niamtu.

These patients presented from other surgeons with pixie earlobes from a previous facelift. Dr. Niamtu corrected the pixie earlobes and revised the facelift.

The patients below were operated on by other surgeons and the pixie earlobe was corrected by Dr. Niamtu. Click for a larger view.

Pixie Ear Lobe corrected by Dr Niamtu
Pixie Ear Lobe corrected by Dr Niamtu
Pixie Ear Lobe corrected by Dr Niamtu
Pixie Ear Lobe repaired by Dr Niamtu

Pixie earlobe repaired by Dr Niamtu, original surgery done by another surgeon

Scar Problems

The patient below was treated by Dr. Niamtu and has normal post facelift scars.  Experienced surgeons spend a lot of time making sure the scars will be optimum.  A graceful scar is the signature of the surgeon.Healed facelift incision, Richmond VA

Improperly placed Scars

Poor scar placement is also a commonly encountered by inexperienced surgeons.  Normally, facelift scars are hidden in the hairline and inside and behind the ear.  When performed correctly on a patient with normal healing they should be difficult to see.  The photo to the right shows a patient operated on by Dr. Niamtu with properly placed scars and excellent healing.

The following images show patients that were operated by other surgeons and not Dr. Niamtu.  The scar placement is improper and stands out as unnatural.

This scar (left) was placed too low where it is very noticeable

This scar (left) was placed too low where it is very noticeable.  If the scar were placed properly and higher in the hairline, it wold be almost totally hidden.  This type of low incision is commonly seen in “short cut” facelift procedures.

This patient was operated on by another surgeon and presented with several problems: The front incision is made in front of the ear instead of hiding it inside the ear and the back incision is too low and visible

This patient (right) was operated by another surgeon and presented with several problems.  The front incision is made in front of the ear instead of hiding it inside the ear and the back incision is too low and visible.  The skin was also stitched under excessive tension which let to the more noticeable scars.

Incomplete Treatment

The patients below had all received “short cut” facelifts that are frequently advertised on TV.  All three of these patients had their facelifts done within two years of these pictures.  Although these franchise facelift companies claim their facelifts are “medical breakthroughs” and “new technologies&sdquo;, in reality they are merely a short cuts and frequently fail to produce natural and lasting results.  All three of these patients were required to have a second procedure to deliver the results they should have had in the first surgery had it been performed correctly.

Remember, there is not short cut to facelift surgery.  If it sounds too good to be true, it probably is.

short cut 'facelift' frequently fails to produce natural and lasting results

Hairline Problems

Facelift problem with a stepped hairline. Dr. Niamtu of Richmond VA can correct this problem.Very careful planning and attention must be paid to the hairline. Failure to do so can cause significant deformities or tell tale signs of a poor facelift. Dr. Niamtu uses carefully designed incision techniques to prevent the loss or movement of the sideburn or “stepping” of the hairline behind the ear.

This patient on the left has a stepped hairline from lack of attention to detail in the facelift incision behind the ear. Although it is more time consuming, it is usually possible to eliminate or minimize this problem.

Photos of hairline problem from a facelift, and a contrasting photo with the correct hairline. Dr. Niamtu of Richmond VA can correct or improve this problem.

The image above shows a normal female sideburn or “temporal hair tuft”. The picture on the right shows an excessively elevated sideburn from another doctor. This type of complication is more difficult to correct, but easy to prevent.

Illustration of facelift incision to preserve the hairline. Richmond VA

Loss of the temporal hairline can be avoided by modifying the facelift incision to preserve the sideburn area. This is the type of incision used by Dr. Niamtu.

If close attention is not paid to the posterior hairline, hairline changes can occur that make it difficult for females to wear their hair up.  Using a hyper-beveled transfollicular incision that gently follows the hairline will allow the hair to regrow through the incision and will usually produce an imperceptible scar.  The arrows below show a typical posterior facelift incision performed by Dr. Niamtu one month after the surgery.

facelift incision gently follows the hairline usually results in an imperceptible scar

Nerve Damage

Fortunately, permanent nerve damage is quite rare.  Most patients will experience transient numbness which will return during the healing period.  Although uncommon, transient nerve weakness can occur during facelift surgery.  This is most commonly a result of stretching or compressing the marginal mandibular, zygomatic or buccal nerves during surgery.  Almost all of this type of nerve damage will return to normal function within 90 days or less.  The patient below has some nerve weakness of the upper lip and is shown 2 weeks after facelift in the left image.  The right image show total return of normal movement 8 weeks after the facelift.

temporary nerve damage example and full return of normal movement 8 weeks after the facelift

The Wind Tunnel Look

Arrows showing the  natural direction skin must be pulled in so the results after a facelift will look naturalThe wind tunnel look or “swept up look” can result from simply having too many facelifts or improper technique. The skin must be pulled in a natural direction to look natural and if this is not done correctly, the existing skin and wrinkles look swept back or up. This is worse in patients with very wrinkled or sun damaged skin. This look is best avoided by careful attention to deep tissue and skin redirection. If patients have excessive wrinkling, simultaneous laser resurfacing can help prevent the “swept up look”.

As stated earlier, any surgeon can have unexpected complications for a variety of reasons. The fact that a surgeon has a complication such as the ones above does not make them a bad doctor, but a pattern of these types of facelift complications would certainly create reservations on the part of a patient. It is always a good idea to see multiple before and after pictures of patients with similar type of aging before choosing a surgeon.