Side Effects of Facelift Surgery

This article introduces the side effects and scars of a facelift. I hope it helps you distinguish a successful surgery from an unsuccessful one.

1. Common Side Effect of Facelift: Hematoma

A hematoma refers to a buildup of blood caused by the rupture of small blood vessels due to increased pressure after surgery. The incidence of hematoma related to facelift surgery has been reported at 1.86% to 9%, which is relatively high compared with other plastic surgeries. Although it is not suitable in Korean practice and is not a widely accepted method even among Western facelift experts, some doctors use a hemostatic net to prevent bleeding, which shows that hematoma is a fairly common side effect in facelifts.

Using a hemostatic net to prevent hematoma

2. Facelift Results Are Absent or Minimal

The lifting procedures currently performed can be broadly divided into three types:

• Devices: Ulthera, Thermage, InMode, etc.

• Procedures: thread lifting

• Surgery: mini facelift, facelift

And the less device-dependent the surgery or procedure is, the more it depends on the surgeon’s hands, so the methods and results of facelifts vary from doctor to doctor. It is difficult to make a uniform statement about the causes of weak or short-lasting results, but...

• If the retaining ligaments were not sufficiently released, or

• If the skin was pulled in a direction that did not improve the sagging area

then the surgical effect can only be minimal. Of course, this disappointment with the result applies not only to mini lifting but also to facelift surgery using the SMAS.

3. Side Effects Related to Facelift Incision Location: Scars and Hairline Deformity

Scars and hairline deformity caused by an inappropriate incision site. a: noticeable scar and hypertrophic scar. b: sideburn loss and hypertrophic scar. c: sideburn loss and unnatural hairline, unnatural tragus, scar d: loss of sideburn, widening of the temple area

These side effects occur when the incision line is not properly determined. In particular, losing the sideburn is not a desirable result from an aesthetic standpoint, and it is especially difficult to accept in male patients. For this reason, experts in facelift surgery determine the incision line in a way that avoids the sideburn disappearing after surgery. The logic that a shorter incision will mean a shorter scar is not something a doctor with basic training in plastic surgery should say. The reason a mini facelift may have limited effect may be that the sagging tissue cannot be pulled in the proper direction, and the placement of the incision line is a factor in determining that proper direction.

4. Ear Deformity Side Effects After Facelift

Ear shape deformities can be broadly divided into:

• Deformation of the earlobe

• Deformation of the tragal cartilage

These two types. In particular, the “pixie ear” deformity is a well-known aftereffect of facelift surgery among patients and is a side effect that should absolutely not occur in order to produce a natural and beautiful result. For more details about pixie ear or ear deformities that occur as side effects after facelift surgery, please refer here.

5. The Face Appears Wider After a Facelift

There are often cases where patients complain that the cheekbones look larger after surgery. This is often entirely caused by the direction in which the SMAS is pulled or by the design of the SMAS.

6. A Face That Looks Surgically Done

In both East and West, results that look like the face is being blown by a strong fan after surgery (windblown, pulled appearance) are not considered good facelift results. This is because a facelift is not simply a procedure that pulls everything upward, but a surgery that should naturally return the face to the appearance of a younger time. An unnatural look can occur depending on the extent of skin dissection and the degree of tension, and whether the face has a “facelifted look” is often judged by the shape around the mouth, commonly called the jocker line deformity.

After two previous facelifts, the sunken shadow extending from around the mouth toward the ear shows a typical jocker line deformity

7. Nerve Damage After Facelift Surgery

Although the probability of occurrence is very low, during consultations patients often ask whether the facial nerve can be injured during facelift surgery. I think this is probably not because it happens frequently, but because it is so devastating when it does occur that many people know about it.

Five major facial nerves

In fact, the likelihood of injuring the facial motor nerve during facelift surgery depends on the surgeon’s technique and anatomical knowledge. If the course of the motor nerve is not sufficiently understood and one carelessly tries to pull on a deep layer, the facial nerve can be injured.

If facial expression becomes asymmetric after surgery performed by an experienced doctor, it often occurs during the process of creating the SMAS flap, and in most cases it recovers naturally after about 3 to 6 months. In particular, if the nerve has multiple branches, its function returns to the same level as before surgery.

8. Things to Consider Before Looking for a Good Facelift Clinic

Surprisingly, many people look for a place that does facelift surgery well, but in reality, many do not have the eye to tell what looks young and beautiful, or to distinguish a good surgery from a bad one. In order to understand the effect of facelift surgery, training to view the face as a whole in a balanced way is essential. Since a facelift usually focuses most strongly on the jawline, the effect of surgery is generally assessed using side-view or 45-degree photos rather than frontal photos.

9. Conclusion

We have looked at the side effects that can occur in a facelift. No doctor wants to create side effects. Also, no matter how experienced a facelift expert may be, the side effect rate can never be 0%. However, as a doctor, it is important to understand the causes of side effects and establish a surgical strategy that can avoid them. And if side effects do occur, the only thing to do is to treat the patient to the best of one’s ability. The patient, too, should trust the doctor they have chosen and cooperate as fully as possible with the treatment plan. From the patient’s point of view, it is a good idea to listen carefully during the consultation to why that particular type of surgery is being recommended and what the benefits and drawbacks are.