Face Lift - Looks Awful Behind the Ears?

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 can wear even close-cropped hair and all everyone will notice is their gorgeous rejuvenated face. Find a surgeon with before/after books you admire and previous patients you can consult with. Good luck with your surgery!

The incision that is made behind the ears during a facelift varies from one patient and surgeon to another. Each surgeon makes their incisions in a slightly different way and will often customize the incision for each individual patient. Patients do heal differently, and some patients will develop widened scars from any surgery, not just facelift procedures. Occasionally there is some bunching of the tissue behind the ears, but this is more common with 2nd or 3rd facelifts rather than a 1st procedure.
In my practice, the incisions are hidden along the hairline and the incision is made in such a way that the hair grows through the incision in order to hide the incision as much as possible. Many patients still feel comfortable wearing their hair up once the incisions have healed.
Also, there are "mini lifts" or "short incision" lifts (the terminology will vary from one surgeon to another) that may not require an incision along the hairline. The tradeoff with these techniques is that in some cases it is not possible to tighten the neck as much as one might like. Be sure to discuss concerns regarding incisions and different available techniques with your surgeon.
All the best,

The healing process in general can take up to one month for the majority of swelling to subside, incisions to close, sutures to come out, and for bruising to completely go away. #Recovery time from a #facelift varies from person to person, but patients can generally expect to be presentable within three weeks from surgery. Patients should expect swelling, bruising, and discoloration of the skin during this phase of recovery (swelling normally goes down after 48 hours; most bruising will go away within two weeks). When the skin is separated from the underlying tissues during surgery, small sensory #nerves are cut. Varying degrees of numbness will be present after surgery and will improve gradually as the nerves reconnect to the skin. This process can take from 2-6 months for face, neck and cheeks, and to 9-12 months for the forehead and scalp. Muscle weakness may also be present around the mouth especially if liposuction is used. This typically recovers fully in the months after surgery. 

As the nerves regenerate, the itching, burning, tingling and shooting #sensations will occur. Ice, moisturizers and gentle #massaging are helpful during this phase of the #healing process. Frequently there is a tight feeling in the neck, jawline and cheek after a facelift. During surgery, not only the skin but the underlying muscles are tightened to create a better and longer lasting result. Additionally, the #swelling will move downward in the first week and the neck will feel even tighter. Do not be alarmed: the sensation will decrease during the first month. 

Some degree of firmness or lumpiness under the skin is normal after surgery and will resolve with time. Local #massage of the areas may accelerate the resolution of this problem, which normally takes 2-4 months to disappear completely.The marks from a facelift can easily hidden with “camouflage” make-up which you can learn how to apply. The scars from a facelift mature within six to twelve months from the surgery date. It is during this time that the rejuvenating effects of the facelift will become apparent and the real result will be seen. If you have certain concerns about the procedures and #healing process, it is recommended to call your board-certified surgeon or their medical staff and discuss those #concerns.

Thank you for your question. In most healthy people without a history of healing irregularities, the surgical scars resulting from a well-performed facelift are rarely an issue. Incisions are designed to result in scars that are concealed within natural curvatures around the ear and hairline. Most patients consider those scars to be acceptable with makeup within 1-2 weeks, although full scar maturation takes many months. Once mature, most scars are imperceptible in normal social interactions, although not entirely invisible upon closer scrutiny.



Lasting bunching is rarely encountered when the incision length is appropriately designed and performed. Some surgeons may attempt to minimize the length of the scar. This may be to shorten the procedure duration or as in response to patient request or perceived preference. When an appropriately long incision is utilized, bunching is minimized. Once patients are educated about this, most understand and approve of the trade-off between a longer incision but less bunching and an often superior result.





The appearance of white scars behind the ears may be minimized by extending the incision high behind the ear and into the post-auricular hairline. This may result in a longer scar, but a more easily camouflaged one. Again, once educated, most patients approve of this trade-off between a longer incision but less visible scar.





A well designed and performed facelift incision, which is appropriately cared for after surgery, generally results in a favorable scar which is rarely a source of patient concern.



Ultimately, the vast majority of patients consider the results of the facelift and appearance of facial rejuvenation to be a very acceptable trade-off for typically inconspicuous scars.

There is an an art to planning a facelift which includes incision placement as well as technical precision of the scar.  All scars go through three phases of healing with an initial redness phase followed later on by rebuilding and maturation of the scar.  Most scar and wound experts agree it takes about a year for a scar to fully mature.  

Facelfit scars are commonly seen as red and can be hypertrophic.  Treatment of scars depends on the type of scars seen and can include the following treatments:

-laser treatments to help both scars and redness of scars 

-injections of kenalog or a combination of kenalog and 5-FU 

-scar revision if poorly positioned scar

The key to great scars after a facelift is to avoid tension on the skin and lift the deeper layer of the face.  Placing too much tension on the skin can make scars wider than ideal.  Meticulous closure technique can also aid in scar appearance.

The most important thing when it comes to scarring after a facelift is surgeon technique. An experienced, double board certified facial plastic surgeon who performs thousands of facelifts will generally have the knowledge, technique, and skill necessary so that the patient ends up with nearly invisible, unnoticeable scars. After care is very important too, making sure to apply any topical treatments your surgeon gives you and staying out of the sun. I recommend researching facial plastic surgeons and looking carefully at their before and after photos to see if you can notice the scarring, read patient testimonials, and of course go in for an in-person consultation before deciding on a surgeon. You should not have to choose between sagging skin or terrible scarring!