Kare Plastic Surgery & Skin Health Center · Santa Monica · Los Angeles
Facelift Scar Revision Los Angeles
Deep Plane Facelift · Scar Revision · Revision Facelift · Dr. Raffy Karamanoukian · (310) 998-5533
If you have already undergone a facelift, necklift, deep plane facelift, or SMAS facelift and are unhappy with the visibility of your scars, there are several surgical and non-surgical solutions that can help you regain confidence. Dr. Karamanoukian is a dual board-certified plastic surgeon and an expert in facelift surgery. He has extensive expertise in redefining preauricular, tragal, and earlobe scars so that they blend in more cohesively with your face.
Dr. Raffy Karamanoukian has the patience, expertise, and scar treatment technology improve your current facelift results by reducing the visibility of your facelift scars. Through meticulous facelift technique, Dr. Karamanoukian can either redo your existing facelift or refine your existing scars to make them blend in to your ear and posterior neck.We modify scars through surgery, laser, or scar modulation.
Facelift Scars and High Tension Closures
The most important clinical insight separating a scar specialist’s view of facelift scarring from the general surgical view is this: visible facelift scars are almost always the consequence of skin tension at closure, not the patient’s genetics. When a facelift achieves its lifting effect by pulling the skin taut — the mechanism of traditional SMAS and skin-only techniques — the closing tension on the skin edge is proportional to the degree of lift attempted. High tension at the tragus, behind the ear, and at the temporal hairline is the direct mechanical cause of the widened, hypertrophic, and keloid scars that patients present with at revision consultations. The skin edge under tension heals under stress, deposits excess collagen, and produces exactly the visible scar the surgeon promised would not occur.
Skin tension or SMAS FAcelift
- Lifting effect achieved by pulling skin taut at closure
- Skin edge under tension — highest scar formation risk
- Tension creates wide, raised, or hypertrophic incision lines
- Results relapse faster as skin tension relaxes over 1–3 years
- Higher risk of distorted tragus, pixie ear, and hairline shift
- Revision scar management required more frequently
Deep Plane Facelift
- Lifting effect achieved by repositioning deep facial tissue plane
- Skin closes completely tension-free — thinnest possible scar
- No mechanical tension on tragal, preauricular, or hairline closure
- Results last 10–15 years as structural repositioning is durable
- Preserves natural tragal contour, earlobe position, hairline
- Scar prevention built into the technique, not managed after
Why Facelift Scars Form: The Six Correctable Causes
Excess skin Tension
The most common cause of visible facelift scars. Skin pulled too tightly at the preauricular or postauricular closure produces a scar under continuous mechanical stress that heals widened, raised, or hypertrophic. Corrected by revision facelift with deep plane repositioning that eliminates skin tension entirely.
Poor Incision Design
Incisions placed across rather than within natural skin folds, tragal incisions placed retrotragally rather than along the natural margin, or temporal extensions that violate the hairline all produce visible scars regardless of technique. Corrected by scar revision with geometrically improved re-incision and proper anatomical alignment.
Keloid Predisposition
Patients with keloid tendency produce exuberant collagen beyond the wound margin regardless of closure technique. Pre-operative keloid risk assessment and post-operative prophylactic management — Vbeam, silicone, corticosteroid — significantly reduce keloid incidence in known at-risk patients at Kare Plastic Surgery.
wound breakdown
Single-layer skin closure without deep layer support leaves the skin bearing the full mechanical load of healing. Layered deep subcutaneous and superficial fascial closure distributes tension away from the skin edge and produces a dramatically thinner, better-healed scar. Absence of layered closure is a common technical deficit in high-volume, lower-cost facelift practices.
Infection or Hematoma
Wound infection and hematoma both dramatically impair scar quality — infection through bacterial collagenase activity that disrupts organized collagen deposition, hematoma through the chronic inflammatory stimulus of lysing blood products in the wound bed. Both complications produce thickened, discolored scars that require active management once the acute process has resolved.
scar hypertrophy
A technically excellent facelift closure managed without post-operative scar protocol produces a worse scar than a technically good closure managed with Vbeam, silicone, sun protection, and massage starting at 4–6 weeks. Post-operative scar management is not optional enhancement — it is a standard component of Dr. Karamanoukian’s facelift protocol initiated at the first post-operative visit.
Scar Protocolimprovement in keloid and hypertrophic facelift scars
4–6 wkOptimal Vbeam start after facelift — target the early vascular scar phase
12 moMinimum wait before revision facelift after primary surgery
10–15 yrDeep plane facelift result longevity — durability reduces repeat-surgery scar risk
Facelift Scar Treatment Approach at Kare Plastic Surgery
Early Post-Operative Scar Management (4–12 Weeks)
Vbeam pulsed dye laser initiated at 4–6 weeks post-facelift targets the abnormal vascularity of the early scar before it matures into established fibrosis. Silicone tape applied daily over the facelift incisions reduces transepidermal water loss and downregulates TGF-β fibroblast activity, the key mediator of scar thickening. Medical-grade sunscreen on all incision sites from 2 weeks onward prevents post-inflammatory hyperpigmentation. This early-intervention window produces the most dramatic improvement in scar quality and is the period during which the final scar outcome is most malleable.
Established Scar Treatment (3–12 Months)
Raised, red, or symptomatic facelift scars at 3–12 months are treated with intralesional triamcinolone acetonide to suppress the overactive fibroblast collagen production driving hypertrophic scar thickening, combined with continued Vbeam sessions every 4–6 weeks to address the vascular component. For scars that are refractory to corticosteroid alone, the 5-FU plus triamcinolone combination protocol deploys synergistic anti-fibrotic mechanisms — DNA synthesis inhibition and collagenase activation — that produce improvement in cases where corticosteroid monotherapy has stalled.
Surgical Scar Revision (12+ Months)
For facelift scars that have matured and are not adequately responding to non-surgical management — or that were produced by poor incision design requiring geometric repositioning — surgical scar revision re-excises the abnormal scar tissue, realigns the incision within the correct anatomical location, and closes in precise anatomical layers without tension. The revised incision site is immediately enrolled in the early post-operative scar management protocol described above, treating the new closure from its first post-operative week to prevent recurrence of the original scar problem.
Revision Facelift for Structural Correction (12+ Months)
When facelift scars are the consequence of fundamental technique failure — a skin-tension closure that has produced widened scars, tragal blunting, pixie ear deformity, or hairline distortion that cannot be corrected by scar revision alone without also addressing the underlying tissue tension — revision facelift with deep plane repositioning is the definitive solution. Dr. Karamanoukian’s extensive revision facelift experience means he operates in scarred tissue with the confidence and technical precision that this demanding re-operative environment requires. Revision facelift is performed no sooner than 12 months after the primary procedure when all scar tissue has fully matured.
Dr. Karamanoukian’s HIDEF Expertise for Facelift Scars
National Scar Authority
Nationally recognized expertise in scar management, wound healing science, and keloid biology. Two decades of post-surgical scar treatment gives Dr. Karamanoukian a clinical database of facelift scar outcomes that directly informs every non-surgical and surgical decision in revision cases. His scar science background is the foundation all other expertise builds on.
Keloid Specialist
Post-facelift keloids — particularly behind the ear — are among the most challenging scar complications in facial plastic surgery. Dr. Karamanoukian’s keloid expertise encompasses the complete treatment spectrum: injection protocols, Vbeam, surgical excision with intraoperative steroid, and the post-excision scar prevention protocol that distinguishes the recurrence rates of specialist vs. generalist keloid management.
Deep Plane Facelift
Dr. Karamanoukian performs the deep plane facelift — the technique that eliminates skin tension at closure and produces the most reliably invisible facelift scars available. For patients planning their first facelift, the deep plane approach is the most effective scar prevention strategy, combining superior longevity with the tension-free closure mechanics that make facelift scars invisible rather than merely concealed.
Revision Facelift Experience
Extensive experience operating in the previously facelift-ed face — scarred, distorted tissue planes, altered anatomy, and the elevated technical demands of revision surgery in a high-visibility location. Dr. Karamanoukian’s UCLA reconstructive training and two decades of facelift experience are the credentials that make revision facelift — the most technically demanding facial rejuvenation surgery — achievable with predictable, natural results.
Had a facelift elsewhere and unhappy with your scar? Dr. Karamanoukian welcomes second-opinion consultations and revision facelift referrals from patients whose primary surgery — performed by any surgeon in Beverly Hills, Los Angeles, or beyond — has produced scars that require expert management. Call (310) 998-5533 or request a consultation online at karesurgery.com.
Related Resources at Kare Plastic Surgery
Kare Plastic Surgery & Skin Health Center · Santa Monica · Near Beverly Hills
Facelift Consultation
Schedule a consultation with Dr. Raffy Karamanoukian, a graduate of the UCLA School of Medicine and dual board-certified plastic surgeon — a nationally recognized scar authority and experienced deep plane and revision facelift surgeon specializing in facelift scar removal and scar revision in Los Angeles and Beverly Hills.