---
title: "Facelift Scars: Placement, Healing and Ways to Reduce Visibility"
url: https://drturner.com.au/blogs/facelift-scars-placement-healing-how-to-hide/
date: 2026-01-26
modified: 2026-07-26
author: "Dr Scott J Turner"
description: "Dr Scott J Turner | Specialist Plastic Surgeon (FRACS) Key Takeaways Facelift incisions are placed in natural creases, shadows and hair-bearing areas where they draw less attention, but they are..."
categories:
  - "Facelift"
image: https://drturner.com.au/wp-content/uploads/2024/04/blogplaceholder-img.svg
word_count: 2398
---

# Facelift Scars: Placement, Healing and Ways to Reduce Visibility

*[Dr Scott J Turner](https://drturner.com.au/dr-scott-turner-sydney-plastic-surgeon/) | Specialist Plastic Surgeon (FRACS)*

> **Key Takeaways** Facelift incisions are placed in natural creases, shadows and hair-bearing areas where they draw less attention, but they are permanent and every facelift leaves scars. Most mature into fine pale lines over twelve to eighteen months, though how visible they remain varies with skin type, genetics, technique and aftercare. Silicone, sun protection and avoiding nicotine are the measures with the strongest evidence behind them. Incision placement can also affect ear and hairline shape, which is worth discussing before surgery rather than after.
Scarring is the concern I hear most often from patients considering a facelift, and it deserves a straight answer rather than reassurance. Every facelift leaves permanent scars. What has changed over recent decades is where they are placed and how much tension they heal under, both of which affect how conspicuous they end up.

This guide covers where incisions sit and why, how they change over the first year, which measures have real evidence behind them, and the ear and hairline changes that incision placement can produce. The [facelift surgery](https://drturner.com.au/procedures/face/facelift/) and [deep plane facelift](https://drturner.com.au/procedures/face/deep-plane-facelift/) pages cover the operations, with the [Brisbane facelift](https://drturner.com.au/locations/brisbane/facelift/) and [Brisbane deep plane facelift](https://drturner.com.au/locations/brisbane/deep-plane-facelift/) pages for Queensland patients.

## Where Facelift Incisions Sit

Incisions are planned rather than improvised, and the principle is to place them where existing anatomy already creates a line: a crease, a shadow, or a border between hair and skin.

**Temple and hairline.** The incision usually begins near the temple, either inside the hairline or at its edge, depending on hairline position and how you wear your hair. A trichophytic incision placed at the hairline border allows hair to grow through the healing scar, which can make the transition less abrupt. For patients considering a [ponytail facelift](https://drturner.com.au/procedures/face/ponytail-facelift/) who habitually wear their hair up, this placement matters more than usual.

**The tragus.** The small cartilage flap in front of the ear canal is a useful landmark. In women the incision commonly passes behind it, so the line sits in the natural transition between cheek and ear. In men the approach differs, because placing the incision behind the tragus draws beard-bearing skin onto the ear, leaving the patient shaving inside the ear canal indefinitely. [Male facelift](https://drturner.com.au/procedures/male/male-facelift/) surgery therefore typically places the incision in front of the tragus.

**Around and behind the ear.** From the tragus the incision continues around the earlobe and into the crease where the ear meets the scalp, then into the hairline behind. This portion matters most when neck work is included. It also heals less predictably than the preauricular portion, partly because of skin tension in that area, so it's worth raising if you regularly wear your hair up.

## Incision Patterns by Technique

| Approach | Temple / hairline | Preauricular / tragal | Earlobe | Postauricular |
| -------- | ----------------- | --------------------- | ------- | ------------- |
| Deep plane facelift | Yes, into or at hairline | Yes, usually post-tragal in women | Around earlobe | Yes, into occipital hairline |
| [Short scar facelift](https://drturner.com.au/procedures/face/short-scar-facelift/) | Yes, shorter extent | Yes | To or just behind earlobe | Not used |
| Ponytail facelift | Hairline only | Not used | Not used | Not used |
| Male facelift | Yes, adjusted for hairline | Pre-tragal, to preserve beard pattern | Around earlobe | Yes, where neck is addressed |

The extent of the incision follows what the operation needs to achieve. A shorter scar is not automatically preferable if the technique it belongs to doesn't address your anatomy, and the [facelift techniques](https://drturner.com.au/procedures/face/facelift/) overview covers how the approaches differ.

## Why Tension Matters More Than Length

The single biggest surgical influence on scar quality is how much tension the skin closure carries.

In a [deep plane facelift](https://drturner.com.au/procedures/face/deep-plane-facelift/), the deeper structures are repositioned and anchored first, so the skin is redraped over an already-supported foundation rather than being pulled tight to hold the lift itself. Skin closed under minimal tension tends to heal as a finer, flatter line. Where skin bears the load of the lift, the scar is more likely to widen over time. The same principle underlies [vertical facelift](https://drturner.com.au/procedures/face/vertical-facelift/) and preservation techniques, and it's covered further in the [deep plane vs SMAS comparison](https://drturner.com.au/blogs/difference-between-deep-plane-and-traditional-facelifts/).

## How Scars Change Over the First Year

Scars don't improve in a straight line, and knowing the pattern prevents a good deal of unnecessary worry.

**Weeks one and two.** Incisions are closed with sutures and sometimes surgical glue. Everything looks red, swollen and bruised, with peak puffiness around days three and four, and the incision lines appear prominent. This reflects increased blood flow and immune activity, which is the repair process working. Sutures typically come out around days five to seven. Crusting should be cleaned away gently as directed, since leaving scabs in place can interfere with healing underneath.

**Weeks three to six.** Fibroblasts arrive and begin laying down collagen. The first collagen produced is disorganised and temporary, which is why scars often look their worst during this period: red, firm, sometimes lumpy. Gentle scar massage is usually cleared around weeks two to three, using a plain moisturiser or silicone gel in small circles for five to ten minutes, a couple of times daily.

**Months two to six.** The remodelling phase replaces early collagen with stronger, better organised fibres, and the blood vessels supplying the healing activity begin to regress, which is why redness fades. Scars often reach peak visibility around month three before improving. If yours still look prominent at twelve weeks, that is not the endpoint; the largest changes typically occur between months four and twelve.

**Six months and beyond.** Scars soften and the colour shifts from pink toward pale. Full maturation takes roughly twelve to eighteen months as collagen continues reorganising. Most mature into fine, flat lines that sit within creases and hair-bearing areas, though how conspicuous they remain varies between individuals.

## Ear and Hairline Changes

Incision placement affects more than the scar line itself, and these considerations belong in the conversation before surgery rather than after.

**Pixie ear deformity.** Where tension pulls downward on the earlobe, the lobe can lose its natural free margin and appear stretched or attached to the cheek. It's one of the more recognisable signs of a previous facelift, and prevention is a matter of managing tension and setting the lobe correctly at closure rather than something the patient can influence afterwards.

**Tragal blunting or retraction.** A post-tragal incision that heals under tension can flatten the tragal contour or draw it inward, changing the shape of the ear's entrance.

**Sideburn and temporal hairline displacement.** Lifting tissue upward can raise the sideburn or shift the temporal hairline backward, which is more noticeable in patients with shorter hair or a naturally high hairline. Incision design, including trichophytic placement, is chosen partly to limit this.

**Postauricular hairline step-off.** Where skin behind the ear is redraped, the hairline can shift, leaving a visible step or misalignment where hair-bearing and non-hair-bearing skin meet.

None of these is inevitable, and all are influenced by surgical planning and individual healing. They are worth raising at consultation, particularly if you wear your hair short or up, since incision design can be adjusted around it. Where they occur and remain troubling, [revision surgery](https://drturner.com.au/procedures/face/revision-facelift/) may be considered once healing has matured.

## What Helps, According to the Evidence

**Silicone.** Sheets or gel, either works, and consistency matters more than brand. Silicone maintains hydration in the outer skin layer, which moderates collagen production and reduces the likelihood of thick, raised scarring. Begin once incisions have fully closed, usually week two or three, and continue for three to six months.

**Sun protection.** Healing skin has reduced natural defences and UV exposure can permanently darken a scar. Hyperpigmentation of an immature scar is difficult to reverse. Avoid direct sun entirely for the first weeks, then use broad-spectrum SPF 30 or higher daily once cleared, continuing for at least twelve months. Physical sunscreens containing zinc oxide or titanium dioxide tend to irritate healing skin less.

**Avoiding nicotine.** Nicotine constricts blood vessels and reduces oxygen delivery to healing skin, and the research consistently shows substantially higher complication rates in smokers, including delayed healing, infection and poorer scarring. Complete cessation of all nicotine products is generally required for a minimum of six to eight weeks before surgery and throughout recovery, with the interval for your procedure confirmed at consultation. The [nicotine and facelift surgery](https://drturner.com.au/blogs/why-stopping-smoking-before-facelift-surgery-is-critical-for-your-results/) guide covers why this matters so much for this operation specifically.

**Nutrition and hydration.** Protein, vitamin C and zinc all contribute to tissue repair and collagen synthesis. Recovery is not the time for restrictive dieting, and adequate hydration supports healing and helps manage swelling.

## Managing Appearance While You Heal

Practical camouflage during the months when scars are still maturing.

**Hair.** For the first three or four weeks, wearing hair down and forward over the ears covers the temporal and preauricular incisions, and face-framing layers help. If you wear your hair short, discuss it before surgery so incision placement can account for it.

**Makeup.** Once incisions are fully closed, usually around two weeks, and your surgeon has cleared it, a green colour corrector neutralises redness and peach or orange tones counteract bruising, followed by concealer and a light foundation. Mineral formulations tend to suit healing skin. Dab or stipple rather than rubbing, which shifts product and disturbs the area. The [recovery after facelift](https://drturner.com.au/blogs/recovery-after-facelift/) guide covers timing.

**Hats and scarves.** Wide-brimmed hats provide both coverage and sun protection. Scarves draped loosely around the hairline and ears work too, provided nothing presses directly on the incisions.

## When Scars Don't Heal Well

**Hypertrophic scars** are red, raised and firm but remain within the borders of the original incision. They usually result from excess collagen production, often driven by wound tension or prolonged inflammation, and generally improve over time. They respond reasonably well to corticosteroid injection, silicone and laser treatment.

**Keloids** extend beyond the original wound margins and continue growing, and they are considerably harder to treat once established. Risk is higher in darker skin phototypes and where there's a personal or family history. If you've formed keloids before, from piercings, injuries or previous surgery, raise it at consultation so preventive measures can be planned in.

**Revision.** Where a scar remains prominent despite good aftercare, revision is an option, but the usual advice is to wait at least twelve months. Scars that look concerning at six months are often substantially better at twelve, and operating early risks treating something that would have resolved while adding a second scar. Vascular lasers can address persistent redness and fractional lasers can improve texture, both worth considering before further surgery.

## What You Can and Cannot Influence

Within your control: following post-operative instructions closely, avoiding all nicotine, protecting scars from sun, using silicone consistently, eating and hydrating well, and attending follow-up appointments.

Outside your control: your genetic tendency to scar, your skin type and how it pigments, and how age affects your healing capacity.

If you have a history of poor scarring, say so at consultation. Additional measures such as early corticosteroid injection or a more intensive silicone regimen can be built into the plan in advance rather than added in response to a problem.

## Setting Expectations

Most facelift patients are satisfied with how their scars heal. Placement in creases, shadows and hair-bearing areas, combined with tension-free closure and consistent aftercare, means that for many patients the scars are not conspicuous in ordinary social settings once mature.

That is not the same as invisible. The scars are permanent, they remain detectable on close inspection in many patients, and how they settle varies with skin type, genetics and healing. Anyone promising scarless facelift surgery is describing something that doesn't exist. Reviewing a surgeon's [before and after gallery](https://drturner.com.au/photos/facelift-before-after-photos/) with scar visibility specifically in mind is more informative than any general reassurance, and individual results vary.

## Frequently Asked Questions

**Where are facelift scars located?** Incisions typically begin at the temple, either in or at the edge of the hairline, run down in front of the ear around the tragus, pass around the earlobe, and continue into the crease behind the ear and back into the hairline. The exact pattern depends on the technique: a short scar facelift omits the portion behind the ear, a ponytail facelift uses hairline incisions only, and male facelift surgery places the preauricular incision in front of the tragus rather than behind it to avoid drawing beard-bearing skin onto the ear.

**Are facelift scars noticeable?** They are permanent and remain detectable on close inspection in many patients, but placement in natural creases, shadows and hair-bearing areas means they are usually not conspicuous in ordinary settings once mature. Visibility varies considerably with skin type, genetics, surgical technique, closure tension and aftercare. No facelift is scarless, and any claim otherwise should be treated with caution.

**How long do facelift scars take to fade?** Scars typically look their worst between weeks three and six, often reach peak visibility around month three, then improve steadily. The largest changes occur between months four and twelve, with full maturation taking roughly twelve to eighteen months as collagen reorganises. A scar that still looks prominent at twelve weeks is not a final result.

**Can a facelift change the shape of my ears or hairline?** It can. Downward tension on the earlobe can produce a pixie ear deformity, where the lobe loses its free margin and appears attached to the cheek. Tension around a post-tragal incision can blunt or retract the tragus. Lifting can also raise the sideburn, shift the temporal hairline backward, or create a step in the hairline behind the ear. These aren't inevitable and are influenced by surgical planning, but they're worth discussing beforehand, particularly if you wear your hair short or pulled back.

**What is the best treatment for facelift scars?** Silicone gel or sheeting has the strongest evidence, started once incisions have fully closed at around week two to three and continued for three to six months. Alongside that, strict sun protection for at least twelve months, complete avoidance of nicotine, gentle scar massage once cleared, and adequate protein and hydration. For scars that remain raised or red despite this, corticosteroid injection and laser treatment are options, and revision surgery is generally deferred until at least twelve months.

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If scarring is your main hesitation about facelift surgery, it's a reasonable one to raise directly at consultation, including how incision placement would work around your hair and ear anatomy. Dr Scott Turner consults in Sydney and Brisbane. For clinic information and the consultation pathway, visit the [Sydney clinic](https://drturner.com.au/locations/sydney-clinic/) or [Brisbane clinic](https://drturner.com.au/locations/brisbane/), or [contact the practice](https://drturner.com.au/contact-us/) to arrange a consultation.