Which type of facelift scars are most noticeable to surgeons?

Well its better to have no scar than a scar. So I see if i can avoid a scar as much as possible, but sometimes there are cases where that is not possible because too much skin needs to be removed. I think going inside the ear is probably better than outside the ear but it depends on the surgeons skill level. Not every surgeon is able to do that and not have it infected, it is called the post-tragal. But I think its better to have no scars if possible!

Hello and thank you for your question. After ANY surgery, the surgical incision goes through multiple stages of wound healing before arriving at the final "mature" scar. Without getting too technical about the stages of wound healing- just know that EVERY incision will ultimately result in a scar. As plastic surgeons, we do our best to hide these scars as much as possible using our intimate knowledge of anatomy, resting skin tension lines, tension vectors of pull, and light/shadow areas. Under the best case scenario (assuming no wound healing issues or infection), these scars should heal as very fine lines which are flat and flush with the surrounding skin- it can take up to 1-2 years to arrive at these final "mature" scars. Also the scars should be very well hidden after a facelift so that they are not obviously noticeable unless you are specifically looking for them and know exactly where to look.
As a plastic surgeon, in addition to looking at the scars themselves, we look for some other telltale signs which giveaway whether a patient had a facelift- mainly pixie ear deformity (an attached and pulled earlobe) and forward retraction of the tragus (of the ear). These can indicate that there was either too much skin resected (resulting in too much pull on the earlobe and tragus, respectively), or that the scarring process itself resulted in more fibrosis and contraction than anticipated (which is difficult if not impossible to predict, and dependent on multiple factors including the patient's own biology/healing process).
Ultimately, if the final scar appearance is cosmetically concerning, this can always be revised electively, usually at least 12 months later so the scar can soften and mature- just note this will reset the healing process. I hope this helps!
Best,
Dr. Donald Groves
Plastic Surgeon

While the typical scars of a facelift (cervicofacial rhytidectomy) are placed anterior to the ear, which is slightly noticeable, these scars tend to heal in a very favorable fashion. There are some patients in which the hairline scars are a bit more noticeable, however I have many patients come in for a repeat procedure in which previous scars from their facelift and brow lift are nearly imperceptible. Good luck with your procedure!