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Face Lift - Looks Awful Behind the Ears?

asked 1 year ago by Jae Rae in Madison, WI
Latest answer by Sam Naficy, MD
Question viewed 1,846 times
Tags: ears, scar

I live in the Madison, WI area and am seriously considering a face lift. The main thing holding me back is how bad it looks behind the ears...even after months/years. I've had a few friends do it and they have "bunching" and prominent, white scaring behind their ears. I've also talked to a few in the industry and apparently this is common? It seems I must decide between sagging or wearing my hair down for the rest of my life?

36 answers to Face Lift - Looks Awful Behind the Ears?

+2

Minimizing facelift scars

Facelift scars can be minimally visible, or keloidal and obvious, or anything in between. Experienced surgeons have better scars.  There is a certain ability that comes after a surgeon has done 1000 facelifts that is simply not present in a doctor who has performed 100. Skill level of the individual surgeon often goes hand in hand with experience, but not always. The technique chosen also determines how scars will appear.  Hairline techniques will always disturb the... more
Brent Moelleken, MD

Beverly Hills Plastic Surgeon

www.drbrent.com

+2

Research Surgeon Carefully to Avoid Bad Facelift Scars

While there is always a risk of scarring after ANY surgical procedure including Face Lift, seek a board certified facial plastic or plastic surgeon with experience, training, expertise, and credentials to provide the best surgery for you. I say to my patients "Good Facial Plastic Surgery doesn't look like surgery, it just looks good!" Face lift scars from a well performed surgery should be virtually invisible - white, flat and well placed behind the ear so that a patient... more
Benjamin Bassichis, MD

Dallas Facial Plastic Surgeon
+1

Face lift incisions

If the incisions behind the ears are planned correctly, the skin is pulled and trimmed in a correct way, and repaired appropriately, the incisions heal extremely well in most circumstances and you can style or pull your hair any way you wish.
Sam Naficy, MD

Seattle Facial Plastic Surgeon
+1

Do all face lift scars look awful behind the ears.

I have performed face lifts for over 20 years and not all face lift scars look bad behind the ears. Bunching is more an indication of an inadequate sized incision placed in the posterior scalp. This causes bunching of the skin as it's redraped prior to its removal. Newer minimal incision face lifts do not have this incision but replace it with a small incision under the chin. Less skin, of the neck, can be removed so there's always a trade off. You... more
Francis R. Palmer, III, MD

Beverly Hills Facial Plastic Surgeon
+1

Proper incision placement and flap distribution prevents tell-tale scars.

It all comes down to having a good plan, good experience and good execution.  If any one of these three factors go awry, a bunched scar can result.  Often the attempt to make a facelift scar too short is the culprit.  The effort to make the scar less apparent (shorter) backfires and it is more conspicuous (bunched).  Tell your surgeon, you'd rather have a longer great scar that is concealed by hair than a shorter visible one.
Ritu Chopra, MD

Beverly Hills Plastic Surgeon
+1

Appropriate incision placement for facelift

It is imperative that you seek out a board certified plastic surgeon well trained in facelift surgery.   There are skillful methods to prevent the obvious signs of facelift patients.   Although assymetries and poor scarring may occur in the best of hands, an experienced facelift surgeon can carefully place incisions both in front and behind your ears that should be very difficult to perceive after appropriate healing time. Widened scar is typically due to tension on the... more
Paul S. Gill, MD

Houston Plastic Surgeon
+1

Scars from a face lift

Unfortunately you see the bad resutls because they are visible but do not see the excellent outcomes because the scars are barely visible. Scars vary for several reasons only some of which can be controlled such as wound tension and smoking history.
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

Small risk of scarring in facelift

This is not true. While scarring is always a risk of facelifts/necklifts, this should be a very small risk, and patients should not settle for surgeons who in fact routinely leave such scarring.
Jeffrey Epstein MD, FACS

Miami Facial Plastic Surgeon
+1

Scarring behind the ears after a facelift should be minimal...

The incision behind the ears in a Facelift procedure should heal into a flat, barely visible incision that is placed into the hairline of the patient.  A  board certified plastic surgeon that is highly skilled in facial plastics has the experience to precisely close the incision around the ear, and the knowledge to ensure the skin lines up correctly so that bunching does not occur.  Every patient  heals differently, and a small minority of... more
Andrew Miller, MD

Edison Facial Plastic Surgeon

www.associatesinplasticsurgery.com

+1

Facelift scars behind the ears

The bunching that occurs after a facelift is due to the wrong vector of pull with excess skin. The excess skin that is redraped behind the ear translated from the neck is then rotated closer up to the ear and bunching occurs. It is important the vector of pull when excising extra skin of the neck goes straight back from the neck to the mastoid area. The placement of incisions is also important so that the patient is still able to place the hair up in a bun after surgery. The incision is... more
William Portuese, MD

Seattle Facial Plastic Surgeon

www.seattlefacial.com

+1

Proper Facelift Technique can minimize bad Facelift scars behind the ears-ask the right questions of your doctor

A Facelift always produces scars, and the worst scars are always behind the ears. However, careful specific Facelift technique can lessen the risk of bad Facelift scars behind the ears. It is important to avoid placing the Facelift incision too low behind the ear. There is always some "pulling down" of the scar behind the ear, and if the scar was placed too low it becomes visible. Discuss this with your surgeon. If the scar is placed high behind the ear it is... more
Brooke R. Seckel, MD

Boston Plastic Surgeon

www.drseckel.com

+1

Scars after facelift should be virtually invisible

Generally the scars behind the ears do not look bad in a facelift. Part of the art of performing a facelift includes the ability to re-drape the skin so that there is minimal or usually no bunching. Scars should be well hidden either in the hair line or at the hair line itself. My best advise is don't go to the doctors who performed surgery on your friends. Seek out a board certified plastic surgeon and look at his postoperative pictures. This should reassure you that you will not... more
Andrew Kaczynski, MD

Sacramento Plastic Surgeon
+1

Prominent, bunched facelift scars are not typical

The scars after facelift surgery should not prevent you from being able to wear your hair back. With attention to detail, the skin should be realligned such that bunching should not be evident long term. By refraining from placing too much tension on the skin itself -- using the deeper tissues to secure the incision line -- the scar should heal as a fine line.  There is some variability in healing and some patients tend to heal with thicker scars regardless of how the incision... more
Thomas A Lamperti, MD

Seattle Facial Plastic Surgeon
+1

You have to look at the doctor's pictures

I actually practice in Madison WI. I think the number one thing about a Facelift is that it should look natural. I always tell patients that if you are just looking at the "after" picture you should NOT say "what a great Facelift". BUT if you look at the before and after pictures together you should definitely have a "wow" impression. I always share real patient photos with patients. You must look at the after pictures closely. How do the scars look? How... more
Benjamin C. Marcus, MD

Madison Facial Plastic Surgeon

www.uwhealth.org

+1

Face Lift - You should be able to wear your hair up.

Though it may be common, it is not the norm to have heavy scarring behind the ear years after a face lift. The posterior hairline should be re-aligned to prevent the appearance of a "step-off". Scarring is minimized by making sure the tension of the lift is placed on the deep tissues and not the skin. Proper technique and healing should allow most patients to wear their hair up without concern after a face lift.
Anand D. Patel, MD

Austin Facial Plastic Surgeon
+1

Scars around the ears after facelift

Properly placed incisions around the ears should leave little or no scarring.  in a woman, the incision should go behind the ear and needs to be placed up on the ear cartilage.  After healing it should pull back into the groove.  In a mini-lift, the incision will end behind the ear.  Good candidates for a mini-lift shouldn't have any bunching.  Those who have too much extra skin in the neck and get a mini-lift instead of a full lift, will have bunching.... more
John Bitner, MD

Salt Lake City Facial Plastic Surgeon

www.drjohnbitner.com

+1

Scars in facelift

Your friend(s) may have had a significant amount of excess skin.  The more redundant the skin in the neck, the more potential for the "bunching up" that you see in order to eliminate the skin without making an incision across the back of the scalp.
Samer W. Cabbabe, MD

Saint Louis Plastic Surgeon
+1

Facelift scars

Yes,  in some cases the scars behind or in front of the ears do not heal as well as one would like, but that is the small minority. Most heal quite well, and if they do not, a scar revision can certainly be performed as a minor office procedure.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Facelift scars.

Once again we run into the artist, craftsman aspect of cosmetic surgery. The reason some Facelift scars look awful is because it takes a great deal of time and effort to corectly make and then close these incisions. This is not the kind of quality you get with a "lunch time" etc. Facelift.  I would recommend you seek out the services of an experienced cosmetic surgeon that you have seen before and after pictures from and let them guide you. In today's environment not all... more
Paul Vitenas, Jr., MD

Houston Plastic Surgeon
+1

Face Lift incisions Behind the Ear

Hi Jae Rae, The benefit of cosmetic surgery of the face and neck should outweigh the risks. Everyone who has surgery will have a scar where the incision was placed. Even the best face lifts by top plastic surgeons will have visible scars, if one looks close enough. Fortunately, most face lift scars are inconspicuous. Regardless of a plastic surgeon's specific face lift or neck lift technique (SMAS lift, MACS, deep plane lift, mini lift, full face, etc), all face lift... more
Houtan Chaboki, MD

Washington DC Facial Plastic Surgeon

www.potomacplasticsurgery.com

+1

Rare to have unsightly scars from facelift

While all incisions are visible in the immediate post-operative recovery period, facelift incisions (especially behind the ear) heal incredibly well if the surgery was performed correctly.  It is very rare to have unsightly scarring from a facelift in the otherwise healthy patient.  Of course, certain skin types may carry a higher risk of keloid formation -- this low risk should be discussed with your surgeon preoperatively.  I strongly recommend analyzing your surgeon's... more
Vishal Banthia, MD

San Jose Facial Plastic Surgeon
+1

Facelift scars should be minimal with no skin bunching.

Your individual anatomy will determine the length of the incisions which will give you the best result for your face lift.  You may not require an incision which goes behind your ear.  That said,  if your incisions are placed in the proper position, they are closed with meticulous technique and they are closed without excess tension on the skin, excellent healing should be the norm, even behind the ear.  Patients should realize they bear some responsibility for their... more
Jeffrey M. Darrow, MD

Boston Plastic Surgeon
+1

Facelift Scarring

On the contrary, most good facelifts should not leave obvious scars. A skilled cosmetic surgeon can rejuvenate your neck in jowls via well hidden incisions, when closed with good surgical technique, heal well enough that they should not be obvious. There is always a possibility that wound healing issues may exist, but this should be the exception not the norm.  I suggest you seek out a skilled surgeon who performs many facelifts a year, and ask to see before and after pictures to see if... more
Anthony Corrado, DO

Philadelphia Facial Plastic Surgeon

www.dranthonycorrado.com

+1

Behind the Ear Face Lift Scars

To limit excessive face lift scarring behind the ear during face lift surgery: 1.  AVOID SMOKING 2.  Limit dissection behind the ear 3.  Limit tension placed on the skin incisions 4.  Limit the amount of skin excision 5.  Utilize SMAS Plication or Excision (i.e. tighten the thin layer of muscle underneath the facial skin) 6.  Utilize Short Scar Face Lift Techniques 7.  Tighten the neck through an incision placed under the chin... more
Jaime Perez MD

Tampa Plastic Surgeon
+1

Facelift Procedures - Technique Matters

Not all facelifts are the same.   Although some degree of scar is required to achieve the more youthful form, the incisions (scar) can be strategically camouflaged even behind the ear.  First, depending on your anatomy, you may not even require an extensive scar behind the ear.  If you do require the retroauricular (behind the ear) incision, the scar can be draped carefully to optimize healing.  Even in the worst case scenario, rare irregularities in the skin or poor... more
C. Bob Basu, MD

Houston Plastic Surgeon
+1

Facelift Scars

You gave no information about yourself, so it is hard to say what you need. Facelifts based on the MACS Lift, a modern facelift technique that elevates the tissues differently, frequently do not require an incision behind the ear. If it does, good plastic surgeons can usually place the scar so that it is all but invisible. Discuss your concerns with whomever you consult.  
Robert T. Buchanan, MD

Highlands Plastic Surgeon
+1

Proper incision design is crucial

Scarring and bunching behind the ears may be the result of an incision that is not properly planned, or as previously-mentioned, when surgeons try to fit a full face-neck lift into a smaller incision. Some of the bunching will soften with time as the swelling improves, but with any medical procedure, it is important to pick a surgeon with whom you feel comfortable as well as seeing before and after photographs, and if possible, speaking to some of the practice's patients who have... more
Gregory J. Vipond, MD

Pasadena Facial Plastic Surgeon
+1

Facelift and Scars Behind the Ears

I completely understand your concerns.  As a Facial Plastic Surgeon, about half of the Facelifts I perform per year are revisions.  Amongst patients who seek a revision or a secondary Facelift, the greatest concern voiced is about the appearance of the scars behind the ears. As with many procedures, there are certain principles that must be followed that will allow for a natural look as opposed to a stigmatic look.  Placement of the incision in the post-auricular/ occipital... more
Stephen Prendiville, MD

Fort Myers Facial Plastic Surgeon

www.drprendiville.com

+1

Avoiding Ugly behind the ears Scars with Facelift Surgery

I completely understand your concern. In your Facelift research you need to consider several factors. An incision (and scar) behind the ear is not always mandatory. Depending on the amount of excess and sagging face and neck skin you have, you may do very well with a Short Scar Facelift procedure (such as MACS) which does not go behind the ears. No incision behind the ear = no scarbehind the ears= no ugly scars behind the ears. In cases of extensive excess face and neck skin excess,... more
Peter A. Aldea, MD

Memphis Plastic Surgeon
+1

Facelift Scarring: Surgical considerations and patient desires

Any aesthetic surgery requiring a surgical incision will create a scar. However, the type and degree of scarring produced is a direct result of the operative procedure, techniques applied and treatment of skin. In a traditional facelift (not a mini-lift) there will be scars produced behind the ears to remove excess skin. There are a variety of techniques used to conceal and minimize these scars through incision location, overall skin tension and treatment of the hairline. Ultimately, the... more
James M. Ridgway, MD

Seattle Facial Plastic Surgeon
+1

Face Lift - Looks Awful Behind the Ears?

You need to see more doctors and results because the scars are in most cases light and not to noticeable. Best of luck. From MIAMI Dr. Darryl J. Blinski
Darryl J. Blinski, MD

Miami Plastic Surgeon
+1

A facelift should not dictate your hairstyle

Well placed incisions for a facelift or rhytidectomy along with good skin redraping and proper vectors of tissue advancement would allow you to wear your hair however you wish to.  Even if meticulous layered wound closure techniques are used, you may have a very fine white incision line.  However, this incision line would only be visible if one were to fold the ear forward and look very closely for an incision.
Anurag Agarwal, MD

Naples Facial Plastic Surgeon
+1

Not all facelifts are the same

The scars from facelifts are a necessity to do the operation however the quality of them depends partly on how an individual heals.  You cannot directly alter this but you CAN impact the quality of the scars by going to the best trained, most experienced, and most artistic Board Certified Plastic Surgeon who will do your surgery without undue tension on the scars.
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon
+1

Concerns with Facelift Scars

Scar lines need to be discussed before any face and neck lift. There is no way of doing a good facelift without incisions. Well placed incisions combined with careful trimming of skin excess and meticulous suture closure should lead to very good healing without noticable scaring or bunching. One exception though represent patients with a genetic tendency to keloid scaring...
Frank P. Fechner, MD

Worcester Facial Plastic Surgeon

www.drfechner.com

+1

Properly place incisions do not create bunching

Where the incision is placed and how it is closed combined with the genetics of the patient will define how the incision heals. After years of study, it has been apparent that virtually all patients who have not had a prior lift can end up with an incision than is positioned high behind the ear so that there is hair on both sides of the majority of the incision.  In this way scar thickening is unlikely and the incision becomes invisible.  The portion of the incision that is on... more
Nathan Mayl, MD

Fort Lauderdale Plastic Surgeon
+1

Skin bunching and scar behind ears after a facelift surgery

Dear face lift patient from Madison, WI, I do not blame you to have concerns in regard to scaring and tissue bunching behind the ear after a facelift surgery. This occurs when some surgeons are trying to convert a full face and neck lift incision into a short scar or a mini facelift incision. What happens is the excess tissue bunches in the back. A seasoned face lift surgeon places accurate and appropriate incision length to achieve the best outcome. A well healed incision line is as... more
Kevin Sadati, DO

Orange County Facial Plastic Surgeon

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