At a glance: does a facelift leave scars?
Yes. I plan facelift incisions along the ears and the hairline, and the neck may need an incision beneath the chin. Scars mature over time and many become less noticeable, but they do not disappear. Before surgery, I show you on your own face where they will be, explain how to care for them and agree on what to do if something does not heal as expected.
- Position: in front of the ear, the incision is pretragal in both men and women; it continues around the ear into the scalp.
- Stitches: removed at 7, 10 and 14 days, during follow-up visits.
- Sun: none for 3 months; from 3 to 6 months, only early or late in the day with SPF 30 to 40; unrestricted after 6 months.
- Maturing: a scar can take 2 years or more to fade.
- Silicone: the Cochrane review of silicone sheets for hypertrophic scars found low or very low certainty evidence.
- Warning signs: warmth, pain, swelling or pus need assessment without waiting for the next visit.
My deep plane facelift guide gives the broader picture of surgery. This article focuses on scars: where they are, how they change, which care makes sense and when a change needs to be checked.
You may like the idea of a more defined contour and still feel uncertain about a mark near your ear. If you wear your hair short or often tie it back, that concern may be central to your decision, and I would not dismiss it by saying the incision will simply be hidden.
Four questions before the operation
Where will my incisions be?
Ask me to show you the planned route and which part belongs to the facelift or to an additional procedure. That is more useful than assuming every facelift uses the same incisions.
What does my healing history tell us?
Mention earlier scars, diagnoses such as keloids and any treatments, even when the scar is elsewhere on your body. Bring records if you have them; you do not need the technical name.
How will changes be assessed?
Know when your visits are and how to reach the team in between. A photo helps describe a concern, but it does not always replace an examination, especially once you are back home.
What can realistically be expected?
I can explain the plan and its limits, not predict exactly how your skin will heal. The goal is an informed decision that weighs the expected improvement against the scars involved.
The position of an incision tells you more than its label
According to the American Society of Plastic Surgeons, a traditional facelift incision often begins in the hairline at the temples, continues around the ear and ends in the lower scalp; a second incision under the chin may be needed to treat the neck [1]. That is the general pattern, not the incision plan for your surgery.
In front of the ear, I place the incision in front of the tragus, the small cartilage in front of the ear canal (a pretragal incision), in both men and women. I would rather show you the planned route than talk about a “small incision”: a shorter line does not, by itself, mean a better operation. What matters is whether the incision allows us to treat what needs treating.
Show me how you usually wear your hair and mention any concern about the ear or hairline. That is not a request to choose a hairstyle to hide surgery; it helps me explain how the incisions relate to the areas you notice most. For men, beard and sideburns need their own discussion, which I cover on my male facelift page.
How to look at photographs of scars and results
Before comparing images of a scar, check when they were taken and whether lighting, angle and distance are comparable. Otherwise, a difference between photos can be mistaken for improvement or deterioration.
With photographs of results, ask how long after surgery they were taken, whether they show the area that concerns you and which procedures were combined. I show cases to discuss possibilities and limits, not as a contract for your result. You can like the overall change and still need more information about your own incisions.
The NHS explains that you cannot get rid of a scar, but most fade over time, which can take up to 2 years or more [2]. That does not mean waiting years to raise a concern; it means an early appearance is not the final one. If you notice a change, tell me when it began, whether it is getting worse and whether there are symptoms. “It is still early” is not an answer to every problem.
The scar care I recommend after surgery
Stitches are removed at the 7, 10 and 14-day visits. Makeup is allowed after 7 days and hair dye after 3 weeks. For sun exposure: none for 3 months; from 3 to 6 months, only early in the morning or late in the afternoon with SPF 30 to 40 sunscreen; after 6 months, no restriction.
Before using any product, establish what is being treated. A wound that has not fully closed is not the same as an established scar. Do not put silicone on an open wound or start massage on your own; the NHS advises massaging a scar only once the wound has fully healed [2]. Tell us what you already use rather than buying several “scar” products in advance.
What does the evidence say about silicone sheets?
A 2021 Cochrane review included 13 randomized trials of silicone gel sheeting for hypertrophic scars. All the evidence was rated low or very low certainty, and the benefit remained uncertain in several comparisons, including against no sheeting [3].
The trials involved scars from different causes, not facelifts. Treating an established hypertrophic scar is also not the same as preventing problems in every new incision. So when I discuss an option, I explain its purpose and follow the response, without promising it will erase the mark; uncertain evidence does not prove that nobody can benefit either.
When a change needs prompt attention
A scar that is swollen or painful, feels warm or has pus coming out of it needs prompt assessment; the NHS lists these as reasons to seek urgent care [2]. Tell the team what has changed and since when, and send a photo through the agreed channel if asked.
Isanna and I provide 24-hour support on WhatsApp, which helps decide the next step but does not always replace an in-person examination. For a serious or rapidly worsening problem, seek urgent local care instead of waiting for a reply to a message.
If the scar keeps bothering you
Describe the specific issue: position, width, raised texture, discomfort or how visible it is in a situation that matters to you. I first examine the area and how it has evolved, then we decide whether the next step is observation, investigation or a particular treatment.
If the scar comes from a previous operation, bring the records. My revision facelift page explains why another operation needs its own plan and cannot promise to erase everything from the earlier one.
Planning follow-up from another country
Include the postoperative visits in your travel plans. I ask you to arrive two days before surgery and stay at least 12 days afterward, preferably 14, so the planned follow-up and stitch removal can take place. That is a scheduling framework, not a guarantee that every wound follows the same timetable or that a particular flight date is medically appropriate.
Some later visits can take place online, but a photo cannot replace every examination. The patient journey explains the full sequence of care.
Questions
Can I see where each incision will be before deciding?
Yes. The planned route is part of the consultation, and I can show which incisions belong to the facelift and which to any additional procedure.
Is the incision in front of the ear different for men?
Not in its position: I use a pretragal incision in both men and women. For men, the beard and sideburns are part of the planning, and I explain this at the consultation.
Should I mention a scar I dislike elsewhere on my body?
Yes, along with any diagnosis or treatment. I will consider what that history adds without assuming every future scar will look the same.
Does an expensive cream guarantee a less visible scar?
No. Price does not determine the result. I need to know what is being treated and at what stage before recommending anything.
Is it reasonable to consult mainly because I worry about scars?
Yes. Understanding them is part of deciding about surgery, and you do not need to have decided to have surgery before we talk.
Bring the concern into the planning
If scars weigh on your decision, write to us on WhatsApp: Bruna, my AI assistant, handles the first contact and then puts you in touch with Isanna to arrange a consultation with me.
References
- American Society of Plastic Surgeons. Facelift Procedure Steps.
- NHS. Scars.
- Jiang Q, Chen J, Tian F, Liu Z. Silicone gel sheeting for treating hypertrophic scars. Cochrane Database Syst Rev. 2021.