Dr. Little’s Philosophies
Scars after Facelift
All plastic surgeons want to minimize the scars of their facelifts, of course, and most do a good job concealing the scar in front of the ear. When the middle portion of the scar is brought inside the ear (as Dr. Little does in both men and women), the remaining portion above (which follows the curve of the “helix” of the ear) and that below (where the lobule joins the face) remain minimally detectable in most patients (so long as tension has been avoided). It is the scar behind the ear that presents the greater problem, forcing some patients into restricted hairstyles after surgery. Dr. Little has been a long-time advocate of elimination of the scar behind the ear that pulls out from the hidden ear groove and descends into or along the hair (see: about Dr. Little / abbr. C.V. Part II: publication #95). A growing number of surgeons now avoid such scars in at least some of their patients (so-called “short-scar” facelift). Dr. Little has avoided them in all of his patients (both men and women) for two decades, allowing each patient an unlimited range of postoperative hairstyles, however short or upswept. He also avoids the scar in front of the temple hairline, where an increasing number of “newer” facelifts now present one. [view: Hidden Omega Incision for Facelift]
He has also eliminated the under-chin or neck scar in almost all patients. In the same spirit, he has eliminated eyelid scars (from both the upper and lower lids) in most patients, as well. To elevate the mouth, he avoids external scars across the lip, preferring hidden scars inside the mouth (sometimes along with short scars limited to the crease under the wings of the nose). To elevate the fallen “witches chin,” he avoids external scars under the chin, preferring, again, a hidden scar inside the mouth. To resuspend the tail of the eyebrow, he most often uses a scar less than one-half inch long, located within the hair of the scalp.
Illustration: Leonardo da Vinci, “Study of Crabs,” Wallraf-Richartz Museum, Cologne[Cheloid or keloid (a thick, unsightly scar) is from the Greek χήλη (crab’s claw)].