How Can Surgeons Hide the Stitches from a Facelift?

Is there any way that the surgeon can put the stitches from a Facelift inside the ear? You can always tell someone has had a lift from those tell-tale incision scars in front of the ear.

Doctor Answers 19

Stitches in facelifts

Most surgeons place the incisions in front if the ear in away that will leave the most inconspicuous scars.  I think what is equally important is to place the incisions in a way that the ears do not look distorted, which is a common problem.

San Diego Plastic Surgeon
5.0 out of 5 stars 20 reviews

Hiding stitches in a facelift

Only a potion of the incision can be placed inside the ear but there is a potion that will have to run around the ear lobe and behind the ear. Meticulous detail to closure is the key.

Facelift Incisions

The key to facelift incisions is to have equivalent shaping to the incisions so there are no straight lines and it matches one of the natural skin creases around, inside the ear, and behind the ear. The goal is to blend the incision with the natural creases so they become almost inconspicuous over time.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 39 reviews

Facelift Incisions

The planning for a facelift incision is a critical step in scar concealment.  Some steps for scar concealment:

  • location and placement of the incision
  • keeping the hairline intact and avoiding hair loss
  • keeping ear position and alignment
  • avoiding excessively wide scars by avoiding tension on skin (lift should be on deeper tissues)

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 114 reviews

Hiding Facelift Incisions

Indeed face lift incisions can be placed inside the ear. The post tragal incision is commonly used. With this approach the Facelift incision begins in the temporal hairline and continues along the edge of the upper ear and behind the small cartilage projection, (tragus), which is in front of the ear canal. This incision then continues around the ear lobe and up behind the ear. This type of incision is used by many plastic surgeons and helps prevent the straight vertical scar in front of the ear. The post tragal incision can provide fine, inconspicuous scars if closed carefully.

This incision presents very few problems in women, however in men it can advance the hair follicles of the beard onto the tragus. Men need to understand this can occur. A man may then need a hair removal procedure to eliminate this undesirable side effect.

Discuss the pros and cons of each type of incision with your doctor before your procedure.

James H. Schmidt, MD (retired)
Sarasota Plastic Surgeon
5.0 out of 5 stars 7 reviews

Minimizing Face Lift Scars

The key to minimizing the appearance of the scar is to put it in the temple hairline, then curve around the top of the ear to just behind the tragus (the cartilage that sticks out in front) then in the crease around the earlobe to the crease just behind it. I have moved to a short scar technique called the Lite Lift in which the scar ends behind the earlobe and does not extend along the hairline in the back so you can wear your hair back

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 99 reviews

Making facelift scars inconspicuous

The incision for a facelift is placed along the tragal edge of the ear, as it is very well camouflaged in this area. Other techniques performed during a facelift to minimize scaring, are to not place any tension along the incision lines so that the incisions do not fall apart and leave wide hypertrophic scars. Another technique is to remove the sutures quite early, day 4 or 5 after the surgery, to prevent railroad tracking along the incision lines.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.5 out of 5 stars 105 reviews

Ways to hide facelift incisions

Good facelift incisions are placed in areas where the scar will be camouflaged or hidden from view. We like to place the temporal incision within the temporal hair region. The incision behind the ear is placed such that the ear and the hair behind the ear will cover the scar. The incision in front of the ear is placed in a skin crease and goes behind the tragus ("inside the ear") in women and in front of the tragus in men.

The reason we don't like to place the incision behind the tragus in men is we don't want facial hair skin to be pulled into the ear. Regardless of where the incisions are placed, meticulous and tension free closure of the wound is critical to good wound healing, resulting in a good cosmetic result.

Corey S. Maas, MD
San Francisco Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Facelift Scars

With very rare exceptions, the scars are placed within the ear. I feel the only reason for placing the incision in front of the ear is that it is easier for the surgeon. In men , where the sideburn hair could be pulled into the ear, the underlying follicles can be destroyed at the time of surgery or later with the use of electrolysis or laser hair removal.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 29 reviews

Facelift Sutures Hidden Scar Line

Question: How can surgeons hide the stitches from a Facelift?

Answer: All incisions should be closed meticulously and without tension. I always place temporal incisions with closure within the anterior temporal hairline. A number of surgeons place these incisions in front of the hairline (in front of the side burn); I disagree with this placement as I feel that it too often presents a conspicuous scar line. Despite my placing the incisions and performing a closure within this hair bearing skin region, I intentionally avoid raising the side burn hairline.

If the incision line is continued behind the tragus (cartilage in front of the ear) and then placed just where the earlobe meets the facial skin, the scar line is relatively inconspicuous. Carrying the incision line in the crease behind the ear and then high into the hairline behind the ear, lining up the hairline, the incision line is relatively inconspicuous.

For the five to seven days that the stitches are present, they may be noticeable on close inspection. However, they may be hidden with the use of judicious hair styling in women (as well as in men). The scar line just under the chin is relatively noticed but the stitches may be seen on close inspection. Keeping the ends of the suture short and the use of clear sutures may be helpful.

Sigmund L. Sattenspiel, MD
Freehold Facial Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.