Facelift Scars

Understanding what to expect about scarring after facelift surgery is an essential part of making an informed decision about your procedure. This guide provides clear, factual information on where incisions are placed, how scars heal, and what factors influence their final appearance.

All surgical procedures create scars—this is an unavoidable part of any operation that involves skin incisions. However, facelift incisions are carefully positioned to minimise visibility whilst providing your surgeon with adequate access to perform the procedure effectively. The appearance of your scars depends on several factors, including the surgical technique used, your individual healing ability, your skin characteristics, and how well you follow post-operative care instructions.

Where Are Facelift Incisions Placed?

Facelift incisions are strategically placed to follow the natural contours of your face. The goal is to hide them as much as possible whilst still allowing your surgeon to achieve the improvements you’re seeking. The exact pattern varies depending on which type of facelift you’re having and your individual anatomy.

Standard Facelift Incision Pattern

Most traditional and deep plane facelift procedures follow this typical incision placement:

Temporal Region: The incision starts within or just along the hairline at your temple, then extends downward toward the natural curve in front of your ear.

Pre-Auricular Area (Front of Ear): The incision continues along the front of your ear, following its natural shape. Some surgeons place the incision directly in front of the ear in the natural crease, whilst others position it just inside the small flap of cartilage that sits in front of your ear canal (called the tragus).

Earlobe and Behind the Ear: The incision curves around your earlobe and travels up behind your ear in the groove between your ear and scalp.

Posterior Hairline: The incision typically ends within the hairline behind your ear. The exact position depends on your hairline and how much work is being done on your neck.

Under the Chin: When neck lift is part of your facelift, you’ll have an additional small incision placed beneath your chin in a natural skin crease. This allows direct access to the neck muscles and deeper structures.

Modified Incision Patterns

Different facelift techniques use variations of the standard pattern:

Short Scar Facelift: Uses shorter incisions that stop at the temporal hairline and front of the ear, ending at or just behind the earlobe. The section behind the ear is eliminated, which reduces the total length of scarring.

Ponytail Facelift: Places all incisions exclusively within the hairline (at the temples and across the forehead), with no incisions around the ears at all. This means you can wear your hair pulled back without any visible evidence of surgery.

Endoscopic Approaches: Use several small incisions within the hairline rather than one continuous incision, allowing the surgeon to work through limited access points using a tiny camera.

Why Incisions Are Placed Where They Are

Regardless of which technique is used, facelift incisions are designed with several important principles in mind:

Positioning within natural skin folds and creases wherever possible
Hiding scars within or along hairlines
Following the natural architecture and curves of the ear
Avoiding areas where tension during healing might widen scars
Staying clear of important facial nerves and blood vessels
Balancing the need for adequate surgical access with the goal of minimal visible scarring

Factors That Influence Scar Appearance

How your facelift scars heal and how visible they eventually become depends on multiple factors. Some of these you can control or improve, whilst others are simply part of your individual biology.

Surgical Technique and Skill

Your surgeon’s experience and technique play a significant role in scar quality:

Incision Design: Precisely placed incisions that follow natural contours and relaxed skin lines heal better. Strategic positioning within hairlines and existing skin creases helps conceal scars effectively.

Gentle Tissue Handling: Careful, delicate technique during surgery minimises trauma to tissues and reduces inflammation that can worsen scarring.

Controlling Bleeding: Thorough control of bleeding during surgery reduces the risk of blood collection (haematoma) under the skin, which can compromise healing and worsen scars.

Closure Technique: Closing incisions in multiple layers—with deeper sutures taking tension off the skin surface—produces finer, less noticeable scars.

Tension Management: Advanced facelift techniques like deep plane and SMAS approaches reposition the underlying support structures of your face rather than relying on skin tension alone. This typically results in better scar quality because the skin isn’t under as much stress.

Your Individual Characteristics

Genetics and Family History: Some people naturally produce more collagen during healing, which creates thicker scars. If you or close family members have a history of keloid scars (scars that grow beyond the original incision) or hypertrophic scars (raised, thickened scars), you may be at higher risk.

Age: Younger patients generally heal faster, but may develop more noticeable scars because their bodies produce more collagen. Older patients often develop finer, less visible scars.

Skin Type and Colour: Your skin type influences healing. Darker skin tones may be more prone to hyperpigmentation (darkening) or hypopigmentation (lightening) around scars. Fair, thin skin may show scars more readily, whilst thicker skin sometimes hides them better.

Smoking: This deserves special emphasis. Nicotine constricts blood vessels, dramatically reducing blood flow to healing tissues. Smokers experience significantly higher rates of poor wound healing, wound breakdown, infection, and poor-quality scarring. If you smoke, complete cessation before and after surgery isn’t optional—it’s essential for safe healing and acceptable scar outcomes.

Medical Conditions: Diabetes, autoimmune disorders, and bleeding disorders can all affect how you heal. Certain medications including blood thinners, immunosuppressants, and steroids can also impair healing.

Nutrition: Your body needs adequate protein, vitamins (particularly C and A), minerals like zinc, and good hydration to heal properly.

How Well You Follow Post-Operative Instructions

Your role in scar outcome cannot be overstated. Adhering carefully to your surgeon’s instructions directly impacts how your scars heal:

Following prescribed wound care routines exactly as directed
Respecting activity restrictions to avoid putting tension on healing incisions
Using recommended scar management products consistently
Avoiding harsh skincare products or putting makeup on too early
Protecting scars from sun exposure diligently

Realistic Expectations About Scar Visibility

Understanding what your scars will look like at different stages helps you plan for recovery with appropriate expectations.

Early Recovery Period (First 3 Months)

During the first few months after surgery, your facelift scars will be clearly visible to anyone who sees you at close range. This is completely normal and expected. Scars typically appear red or pink, may be slightly raised or firm, and cannot be effectively hidden with makeup initially.

This temporary visibility is why many patients schedule time away from work and social commitments during the first 2-4 weeks after surgery. You’ll want to allow the initial, most obvious phase of healing to progress before returning to your normal routine.

Intermediate Healing Phase (3-6 Months)

By three to six months after surgery, your scars will have faded considerably but remain noticeable if someone looks closely. However, during normal casual conversation at typical social distances, most people won’t specifically notice scar lines unless they’re looking for them.

This is often when patients find that friends and colleagues comment that they look “well-rested,” “refreshed,” or “great” without actually identifying that surgery is the reason for the improvement.

Mature Scars (12-18 Months)

Well-healed facelift scars typically mature to fine, pale lines that blend into natural skin creases and hairlines. At this stage, they become extremely difficult to detect during normal social interaction. Only upon very close inspection—closer than most daily interactions—might someone discern subtle scar lines.

Scars hidden within hairlines become virtually invisible. Scars around the ears blend into the natural ear architecture. Most people will not be able to tell you’ve had facelift surgery simply by looking at your scars.

The Reality About “Invisible” Scars

It’s important to understand that no surgical scar is completely invisible under extremely close scrutiny. However, well-placed and well-healed facelift scars can become so subtle that they’re effectively undetectable during real-world daily activities.

The goal isn’t perfection under a magnifying glass—it’s practical concealment during actual life situations: normal conversations, professional meetings, social gatherings, close relationships, and intimate moments. The vast majority of patients find that their mature facelift scars meet or exceed their expectations for concealment.

Why Scars Look Different on Different People

Scar appearance varies significantly between individuals due to genetic factors, skin characteristics, healing capacity, and how carefully post-operative instructions are followed. Some patients develop barely perceptible scars, whilst others may have more noticeable lines despite optimal surgical technique and diligent care.

During your consultation at Dr Turner’s Sydney practice, he can discuss what to realistically expect based on your individual characteristics and the type of facelift procedure recommended for your specific concerns.

Scar Management and Care

Taking proper care of your incisions and following evidence-based scar management strategies will optimise healing and improve the final appearance of your scars.

Sun Protection: The Single Most Important Factor You Control

Protecting your scars from ultraviolet (UV) radiation is the most important thing you can do to influence how they look. UV exposure causes hyperpigmentation—darkening of scars—that can persist for years and is extremely difficult to reverse.

During Initial Healing (First 3 Months): Complete sun avoidance of your healing incisions is ideal. When sun exposure is unavoidable, cover your scars with clothing, hats, or opaque dressing materials. Don’t apply sunscreen directly to incisions until they’re completely healed and all sutures have been removed.

During Scar Maturation (Months 3-18): Apply broad-spectrum SPF 50+ sunscreen to all scar areas whenever you’ll be outdoors. Physical sunscreens containing zinc oxide or titanium dioxide provide the best protection. Reapply every 2 hours if you’re spending extended time outside. Wide-brimmed hats provide additional protection for scars along your hairline and temples.

Long-Term Protection: Even after your scars have completely matured, continued sun protection prevents darkening and maintains scar quality indefinitely.

Practical Daily Steps for Optimal Healing

Follow Instructions Exactly: Your surgeon will provide specific wound care protocols including how to clean your incisions, manage dressings, and when to resume various activities. Follow these instructions precisely.

Stop Smoking Completely: Avoid all tobacco and nicotine products—including cigarettes, vaping, patches, and gum. These dramatically impair healing and significantly worsen scars.

Eat Well and Stay Hydrated: Your body needs good nutrition to heal. Ensure adequate protein intake and eat foods rich in vitamin C, vitamin A, and zinc. Drink plenty of water.

Respect Activity Restrictions: Don’t rush back to strenuous activity. Premature return to vigorous exercise can put tension on healing incisions, potentially widening scars or causing wound separation.

Attend All Follow-Up Appointments: Keep every scheduled appointment at Dr Turner’s Sydney practice so your healing can be monitored and any concerns addressed promptly.

Topical Products That Actually Help

Silicone Products: Silicone sheeting or gel is the most research-supported topical treatment for improving scars. These products help regulate collagen production and reduce excessive scar formation. You typically start using them 2-4 weeks after surgery once your incisions are fully sealed. Consistent use for 3-6 months provides the best benefit.

Prescription Treatments: If you develop thickened scars or concerning darkening, Dr Turner may recommend prescription topical treatments including corticosteroid preparations (to reduce thickening) or hydroquinone-based products (to lighten hyperpigmentation).

Dr Turner will provide specific recommendations about appropriate scar management products based on how your individual healing progresses at your follow-up appointments.

Scar Massage

If your scars develop firmness or start feeling thick, gentle massage can help improve their flexibility:

Use your fingertips to massage in small circles
Apply light pressure—it shouldn’t be painful
Massage for 2-3 minutes, 2-3 times daily
Only begin massage once incisions are completely closed and Dr Turner has given approval

Massage helps break down excessive collagen deposits and softens thickened scar tissue.

When You Can Start Wearing Makeup

Don’t apply makeup until your skin has completely closed and all sutures have been removed—typically 10-14 days after surgery. Once Dr Turner confirms your incisions are fully sealed, gentle makeup application is fine.

Use clean applicators and avoid rubbing the incision areas. Mineral-based or hypoallergenic makeup reduces the risk of irritation. Remove makeup gently each evening with a mild cleanser.

During the intermediate healing phase when scars are pink but fully closed, colour-correcting makeup can effectively hide discolouration. Green-tinted colour correctors neutralise redness, whilst skin-toned concealers provide coverage.

Additional Treatments for Problematic Scars

Most facelift scars heal well without requiring additional treatment beyond basic care. However, certain problems may benefit from additional interventions:

Thick, Raised Scars (Hypertrophic Scars): Can be treated with steroid injections directly into the scar, silicone products, specialised laser treatment, or in select cases, surgical revision.

Darkened Scars (Hyperpigmentation): Can be improved with prescription-strength topical lightening agents, chemical peels, or laser treatments specifically designed to reduce pigmentation.

Widened Scars: If scars stretch wider than expected, surgical revision may be considered once the scar has completely matured—typically 12-18 months after your original surgery.

Keloid Scars: Scars that grow beyond the original incision boundaries are rare in facial surgery. Treatment options include steroid injections, silicone products, cryotherapy (freezing), laser treatments, or surgical removal combined with other therapies to prevent recurrence.

When Surgical Revision Might Be Appropriate

Scar revision surgery can potentially improve unfavourable scars in certain situations. However, revision is only considered after your scars have completely matured (at least 12-18 months) and when conservative treatments haven’t provided sufficient improvement.

Surgical revision involves removing the existing scar and closing the wound again with meticulous technique. It’s important to understand that revision doesn’t guarantee better results—some people simply heal with similar patterns regardless of refinements in technique.

A thorough assessment during consultation at Dr Turner’s Sydney practice can determine whether scar revision offers a reasonable likelihood of meaningful improvement for your specific situation.