Question: About four years ago, I had a facelift. Now I have keloids in front and behind my ears that are both itchy and sensitive. Should I seek out plastic surgery to remove these or will they go away on their own?

Answer: Keloids never go away on their own and if they are still itchy and sensitive, I would recommend an evaluation since frequently injections of a dilute steroid solution cannot only improve the itchiness and sensitivity but can also improve the appearance of these undesirable scars. If the scars are already overly large and quite conspicuous, you may want to consider revision surgery where the scars are excised and the resulting defect is closed with sutures. This, obviously, will just mimic the closure from your previous facelift but the more important aspect of this is followup with the surgeon so that early injections of steroid solution can hopefully prevent these keloids from reoccurring.

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Question: Are there any less invasive techniques than skin grafting to remove severe burn scars?

Answer: It really depends on the appearance of the actual scars for what treatment modality would be best, and there are certainly less invasive techniques than skin grafting to treat burn scars. If there are just some irregularities to the texture of the skin due to the burn, this can frequently be improved with a treatment with the ProFractional Laser, which is a fractionated Erbium laser, which essentially vaporizes small, thin tunnels in the skin, which then cause new collagen deposition and remodeling of the actual skin thus improving the appearance of the scarring; however, if the scarring is quite severe, this may not be your best option and if it is an enlarged area, I would actually recommend seeing a burn specialist.

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Question: I am wondering if you can give an estimate on how long the results of an endoscopic browlift should last. I had one almost four years ago (I was 58 at the time) and I am now noticing that my forehead and brows are starting to droop again. Is it normal for this to happen?

Answer: I believe that the majority of browlift results will last a lifetime and I also believe that the majority of patients that require a browlift later in life actually started with low-set brows when they were young. Brows do droop a little bit and they deflate as they lose volume from the aging process and this process will continue throughout their life, so the brows will drop slightly over time, but usually patients get enough improvement from a browlift that later in life, even with the additional aging, they typically will not need another browlift. I have had many patients who have had browlifts earlier in life who then see me for facelift and frequently will go ahead and touch up the browlift along the sides to help improve their overall look. This certainly does not mean that we are performing another browlift, but what is called a lateral browlift does help with the harmony of an extended SMAS deep plane facelift, so I will commonly perform these together.

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Question: I am a 57-year-old woman who recently had a facelift. I am very satisfied with the results right now but how can I expect my face to look over the next ten years?

Answer: The answer to that question really depends on what technique of facelift was performed and whether or not additional work was performed underneath the chin to tighten those muscles. My personal opinion is that an extended SMAS deep plane facelift in combination with muscle work under the chin will be extremely long-lasting, and I typically will tell my patients that they should look better than the appearance they had
prior to surgery for a good ten years; furthermore, they should age with a very natural appearance so that even when they do show signs of early aging later on, this still looks very natural.

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Question: Would getting a facelift have any affect on the frown lines around my mouth? If not, are there any procedures that can be done in addition to a facelift that would eliminate frown lines?

Answer: Well, the facelift will typically help the lines that go from the corner of the mouth down towards the jawbone, and a deep plane facelift can improve the lines from the nose down towards the corner of the mouth as well as those lines from the corner of the mouth down towards the jawbone. A deep plane facelift, when performed properly, can also slightly lift the corners of the mouth while it certainly will not put any tension on the mouth or create any sort of look of surgery. If you are complaining about lines in the skin or wrinkles then frequently we will go ahead and perform a laser resurfacing at the same time as the facelift to eliminate any deeper lines or creases in the skin. These procedures can be safely performed together so that downtime is minimized.

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