Acne Scarring and Facelift Surgery
A facelift is not a treatment for acne scarring, but repositioning the deeper tissue layers changes how some scar types read on the face. What happens depends on which kind of scar you have.
Acne scarring tends to become more conspicuous with age, not less. As the skin loses collagen and elastin, the surrounding tissue no longer supports the scar and the contrast becomes sharper. Patients who had learned to ignore scarring in their twenties often notice it again in their fifties.
Why the scars formed
Inflammation in an acne lesion damages the collagen and elastin fibres in the dermis. The skin repairs, but the repaired tissue is structurally different from what it replaced. Depending on whether tissue was lost or over-produced during that repair, the result is either a depression or a raised scar.
The two families of scar
Atrophic scars are pitted or indented, and divide into three patterns:
- Ice pick — small, deep, narrow holes.
- Rolling — shallow, with a wave-like surface and no defined edge.
- Boxcar — deep and wide, with sharply defined edges.
Hypertrophic and keloid scars are raised. Hypertrophic scars are usually smaller and confined to the original lesion, most often on the chest, back and shoulders. Keloids extend beyond the original site and can continue growing after healing; on the face they occur most often along the jawline.
What a facelift changes
The answer depends on scar type and depth. A deep plane facelift releases the deeper skin and soft tissue layers from their attachments to the underlying bone, which allows the tissue to be repositioned rather than the surface simply being pulled tighter.
That repositioning affects the way sunken, indented, raised and rolling scars sit on the face. It does not remove them, and a facelift is not undertaken in order to treat acne scarring.
What does treat scarring
- Microneedling creates controlled micro-injuries that stimulate collagen production.
- Dermal fillers restore volume beneath a depressed scar and may stimulate collagen at the site.
- Dermabrasion resurfaces the skin mechanically.
- Dermaplaning removes the superficial layer with a blade.
Which of these is appropriate depends on whether your scars are atrophic or raised, and on how deep they go — an ice pick scar and a rolling scar do not respond to the same treatment.
Dr. Demetris Stavrou is a board-certified plastic surgeon practising in Cyprus, Greece and Malta.
The procedure this relates to
Rhytidectomy — surgery that addresses the descent of the face and neck by repositioning the deeper tissues, tightening the underlying muscle and removing the skin that is left over. Results typically last up to ten years.
Before you act on this
Everything here is general. What applies to you depends on your anatomy, your history and what you are trying to achieve, and none of that can be assessed from a page. If a question here is yours, bring it to a consultation.