Introduction: Embracing Rejuvenation, Understanding Healing
Choosing to undergo facial rejuvenation surgery, like a facelift, neck lift, or blepharoplasty, is a significant step towards restoring a more youthful and refreshed appearance. As a double board-certified plastic surgeon with extensive international experience, I understand the desire for natural-looking, beautiful results. Patients travel from the USA, UK, Canada, Australia, and beyond to my clinic in Istanbul, seeking not just surgical expertise, but a comprehensive approach to their transformation.
While the focus is often on the lifting and tightening effects, a common and valid question arises: "What about the scars?" It's a natural concern. Scars are an inevitable part of any surgical procedure. However, meticulous surgical technique combined with diligent post-operative care can make a world of difference in how these scars heal and mature over time. My philosophy is built on precision during surgery and empowered patient participation afterwards. Excellent results are a partnership, and managing scar healing is a crucial part of that journey.
Understanding Facelift Scars: Placement and Purpose
During facelift and neck lift procedures, incisions are strategically placed to be as inconspicuous as possible. Typically, they follow natural contours – hidden within the hairline, discreetly tracing the front and back of the ear, and sometimes involving a small incision under the chin (especially with chin liposuction or neck lifts). The goal is always to minimize visibility once healing is complete.
Scars form as the body's natural way of repairing tissue. Initially, they may appear red, slightly raised, and more noticeable. This is a normal part of the healing cascade. Over months, with proper care, these scars gradually fade, soften, and flatten, blending more seamlessly with the surrounding skin. Our goal with post-operative scar treatment is to guide this natural process towards the best possible aesthetic outcome.
Read my blog: 'Facelift Incisions: Most Common Cause for Face Lift Revision'
Dr. CBS's Protocol: A Proactive Approach to Scar Management
Based on my experience and continuous learning at international congresses, I've developed a specific protocol that I recommend to my patients. It’s designed to create the optimal environment for scar healing and maturation. Remember, consistency is key.
Phase 1: The Foundation (Starting 2 Weeks Post-Surgery)
Two critical components begin approximately two weeks after your surgery, once the initial healing allows:
Silicone Gel Application: This is a cornerstone of modern scar therapy. Applying a medical-grade silicone gel directly to the healing incisions twice daily is highly recommended.
Why Silicone? Silicone creates a protective barrier over the scar, hydrating the tissue and regulating collagen production. This helps to prevent excessive collagen buildup, which can lead to raised (hypertrophic) or widened scars. It creates an environment conducive to softer, flatter, and less pigmented scars.
How to Use: Gently apply a thin layer of the gel over the entire length of your scars, morning and evening. Allow it to dry before applying makeup or sunscreen.
Duration: Consistency is vital. I advise continuing this routine for a minimum of six months. Scar maturation is a long process, and this dedication pays off.
Sun Protection (SPF 50+): Protecting your healing skin and scars from ultraviolet (UV) radiation is non-negotiable.
Why SPF? Healing skin and new scars are extremely susceptible to sun damage and hyperpigmentation (darkening). Sun exposure can make scars darker, redder, and more noticeable, potentially permanently.
How to Use: Apply a broad-spectrum sunscreen with an SPF of 50 or higher to your entire face and neck, paying special attention to the scar lines, every single day. Reapply as needed, especially if you are outdoors for extended periods. This isn't just for sunny days; UV rays penetrate clouds.
Duration: Like silicone gel, maintain this strict sun protection routine for at least six months post-surgery. Honestly, protecting your facial skin with high SPF daily is a great habit for life, preserving your surgical results and overall skin health.
Phase 2: Enhancing the Process (Starting 1 Month Post-Surgery)
Once the scars have gained sufficient strength, usually around one month after your surgery, we introduce gentle massage:
Daily Scar Massage: Dedicate about five minutes each day, perhaps before sleep, to gently massage your scars.
Why Massage? Gentle massage helps to break down early scar tissue, increase flexibility, and improve blood circulation to the area. It encourages the scar to remodel in a flatter, softer configuration and can help alleviate any tightness.
How to Massage: Using clean fingers, apply gentle but firm pressure along the length of the scar. You can use small circular motions or strokes along the scar line. It should not be painful.
Optional Enhancement: Hypericum Oil (St. John's Wort Oil): While optional, massaging with a small amount of Hypericum perforatum oil (St. John's Wort oil) can be very beneficial. This oil has been traditionally recognised for its soothing and skin-conditioning properties, which can complement the massage process. Use it sparingly during your 5-minute massage routine.
Advanced Technology: The Power of CO2 Laser
For further refinement, Fractional CO2 laser treatment is an incredibly powerful tool in our scar management arsenal.
What is CO2 Laser? This laser delivers precise beams of energy into the skin, creating micro-injuries. This process stimulates the body's natural healing response, promoting collagen remodeling and resurfacing the scar tissue. It can significantly improve the texture, colour, and overall appearance of scars.
When to Start: We can typically begin CO2 laser sessions about one month after surgery.
What to Expect: Often, a series of sessions yields the best results, spaced several weeks apart. It's a well-tolerated procedure that effectively targets residual redness, uneven texture, or slight elevation in the scar line.
Managing Expectations: The Individual Nature of Healing
It's crucial to understand that scar healing is not just about following a protocol; it's also deeply individual. Factors like your genetics, skin type, age, overall health, and how meticulously you follow post-operative instructions all play a role.
Even patients who follow every recommendation perfectly may find their scars heal differently than expected. Some individuals are genetically predisposed to more noticeable scarring (like hypertrophic scars or keloids, though keloids are rarer in facelift incisions). This doesn't mean failure; it simply means your body has its unique healing signature. My approach is cool and realistic – we aim for the best, prepare for variations, and always have solutions.
When Scars Need Extra Attention: Scar Revision
The good news is that even if a scar doesn't mature as ideally as we'd hoped, we don't just accept it. If a scar remains noticeably raised, wide, or otherwise conspicuous after sufficient healing time (usually 6-12 months), a scar revision procedure is often an excellent option.
Scar revision is typically a minor surgical procedure, often performed comfortably under local anesthesia right here in the clinic. It involves carefully excising the old scar tissue and re-closing the incision using meticulous techniques designed to promote better healing the second time around. It's a targeted solution to refine the final result further.
Conclusion: Your Partner in Healing
Achieving beautiful, natural-looking facial rejuvenation is a journey that extends beyond the operating room. Meticulous surgical technique lays the foundation, but your commitment to post-operative care, particularly scar management, is what helps perfect the final outcome.
As your surgeon, I am dedicated to providing you with the best possible techniques and guidance throughout this process. Following the recommended protocol of silicone gel, diligent sun protection, scar massage, and considering treatments like CO2 laser gives your scars the best chance to heal beautifully. And remember, should any challenges arise, we have effective solutions like scar revision available.
If you have any questions about facelift scars or the healing process, don't hesitate to reach out. Open communication is key to our partnership.
Warmly and Professionally,
Dr. Cem Berkay SINACI
Double Board Certified Plastic Surgeon
ISAPS Member
Istanbul, Turkey
