Mike Nayak, M.D.
"In my practice, a good short-scar lift candidate is a patient with excellent skin tone and elasticity who needs limited improvement of the jawline only, or a patient with excellent skin tone and elasticity in need of improvement of the neck only. The anterior-only short-scar technique allows for thorough treatment of the jowls with only modest neck improvement, and the posterior-only technique allows for excellent treatment of the neck with modest jowl improvement."Due to the shorter incisions, the vectors of skin excision are limited, and I must rely on the skin's elasticity to accommodate the excess in some dimensions. When elasticity is poor or skin quality is crepey, a full anterior and posterior incision approach allows for complete redraping and tailoring of this skin. On occasion, the degree of laxity and inelasticity is surprising intraoperatively, and I obtain permission from all of my short-scar facelift patients to convert to a full-incision technique if necessary during the surgery.
"Interestingly, as my practice develops, I find myself utilizing the short-scar techniques more infrequently. Well-healed incision lines are generally not cosmetically objectionable, and to achieve excellent redraping and incision approximation, it is often desirable to make longer incisions to allow for appropriate Burrow's triangle tailoring. While these longer incisions take longer to close, the access they afford generally lends efficiency to the deeper portions of the face- and necklift. Due to that efficiency, I generally find that the longer-scar approaches take me no longer to perform than the short-scar techniques.
"On balance, I find the best feature of the short-scar techniques to be their patient appeal, and it is for this reason I continue to offer them. In the appropriate patient, a short-scar facelift can create an amazing change, with less dissection and less recovery."