One of the most common questions heard in my office is “How will I look after my surgery?” As simple as this question seems, the answer is very complicated. The age of the patient, quality of the skin and degree of the problem being addressed are important factors.
Another equally important factor is your ethnic background as this determines many of the aging and healing characteristics of your skin. Asians, for example, show later signs of aging then Anglo-Saxon, but heal more slowly and sometimes develop thicker scars. The results of facelift surgery often last longer in those with a Mediterranean complexion.
It must be stressed that all facial plastic surgery in which incisions are required involves scarring. Often, scarring is minimal, but it cannot be totally eliminated. Seven basic skin types have been identified, and all are affected in different ways by both the aging process and facial plastic surgery procedures.
Below I will outline the basic skin types.
Type 1: Anglo Saxon- Fair, dry, thin skinned complexion.
The signs of aging appear early. Facial surgery scars are usually quite thin. The skin drapes well often producing excellent facelift results. Fine, deep vertical lines around the mouth and fine horizontal wrinkles (crows feet) around the eyes may be difficult to eliminate and require the use of chemical peel solutions.
Type 2: Northern European- Fair, blue-eyed, blond complexion. Signs of aging appear early. Facelift and eyelid surgery scars are usually thin, almost invisible. Skin heals weel after a facelift. Fine, deep vertical wrinkles around the mouth and fine horizontal wrinkles (crow’s feet) around the eyes may be difficult to eliminate and require the use of chemical peel solutions.
Type 3: Redhead- Ruddy, freckled complexion. Signs of aging appear later. Fine scars are usual after facelift and eyelid surgery, though quality of the scar is somewhat less predictable, with some chance of post operative pigmentation. Skin cancers are most common in this group.
Type 4: Southern European- Darker, oily, brunette complexion. Fine wrinkling of the face is less common and signs of aging appear later. Fine scars are not usual after facial plastic surgery. Scarring in front of and behind the ears may be heavier. Heavier skin resists lifting somewhat. Darker scarring can be more common.
Type 5: Greek, Turkish- Oily, olive dark complexion. Signs of aging appear later, heavy and darker scars are common. Skin cancers are rare.
Type 6: Black complexion.- Signs of aging appear very late. No fine wrinkling. Keloids (excessive tissue scarring) and dark or light pigmentation changes are possible. The nose is often wide which can be improved by narrowing the nasal bones, as well as, the base of the nose. Enhancement of the nasal bridge is often also necessary to give additional height and strength to this area. Heavy skin resists lifting. Skin cancers are very rare.
Type 7: Far Eastern complexion. Signs of aging appear lat with no fine wrinkling. Scarring in front of and behind the ear may be heavier. Heavier skin resists lifting somewhat. Darker scarring can be more common. Low nasal bridge often requires enhancement to give additional height. Symmetry and permanence of new eyelid creases can be surgically accomplished, though additional surgical steps are necessary to create the eyelid crease.
Keeping your skin type in mind, the manner in which your skin has aged and the nature of the problem you are concerned about, your facial plastic surgeon will advise you what realistic gains can be expected from surgery. There may be certain procedures that may be inadvisable because of your skin type (eg. Chemical peels, dermabrasion, etc.). Your surgeon will discuss them with you.