Should I expect faint scarring after a facelift and will this be noticeable to others?

Question

I see so many questions posed about scars and lower facelift. I know most doctors on here are incredible and perform perfect incisions... but, can I honestly expect some faint white lines around my ears and lower part of sideburns? Will someone who is close enough see the faint scars? Doctors I have consulted are experienced and all say they perform wonderful impeccable incisions. I'm fare and always have faint white lines after incisions.

Jonathan Kulbersh, MD · Answer

Thank you for your question. When performed by an experienced facial plastic surgeon, a facelift can provide favorable, natural-looking results with minimal scarring. Inconspicuously placing incisions under the chin, behind the ears, and around the temples and hairline can ensure that any scarring is minimal and concealed. Closing the incisions with deep sutures and no tension can also allow them to heal to the point of being nearly invisible. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon who can discuss your scarring concerns with you prior to surgery and review their techniques for keeping them concealed.

Ozge Ergun, MD · Answer

A facelift, also known as rhytidectomy, is a surgical procedure that is used to improve the appearance of the face by tightening and repositioning the underlying skin and tissue. Like any surgical procedure, facelift does involve incisions, and these incisions can result in scarring. The scarring depends on the surgical technique and the individual's healing process. The incisions for a facelift are usually made in discreet locations, such as behind the hairline and within the natural creases of the face, in order to minimize the visibility of the scars. However, scars can be more noticeable on some individuals than others. The scars may appear as faint lines initially and can take up to a year to fade, but they will continue to fade over time and become less noticeable. Most plastic surgeon will make an effort to conceal the scars in the natural creases of the face, such as in the hairline or behind the ears. However, it's also important to keep in mind that scarring is a normal part of the healing process and that the goal of the facelift is to improve the overall appearance of the face, not to eliminate all signs of surgery. It's important to have realistic expectations about the scarring and to discuss any concerns about scarring with your surgeon before undergoing the procedure.

Donald Groves, MD · Answer

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- 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. If the final scar appearance is cosmetically concerning, this can always be revised electively- just note this will reset the healing process. I hope this helps! 
Best, 
Dr. Donald Groves 
Plastic Surgeon

Ryan Rebowe, MD · Answer

No matter how meticulous your surgeon is, there will always be a scar present after an incision is made. Your thoughts are correct that there will always be a faint white scar likely at your incision sites. However, these scars do heal very favorably following a facelift typically and it is highly unlikely that they will be noticeable to anyone except you and your surgeon. Even if there is some scar widening, a simple scar revision will most likely fix it. While scars from surgery are always a cause of anxiety, thankfully during facelift surgery this is not typically an issue.

Stephen Prendiville, MD · Answer

The key to imperceptible scars after a facelift starts with incision planning, proceeds with a deep plane facelift approach, and ends with no tension on the skin at the end of the case.  It's important to see a facelift expert, who specializes in facelift surgery.  Ask the Surgeon how many facelifts that he/she performs per year.  It should be in the range of 100 per year or more

Brian Biggerstaff, MD · Answer

Hello gigigirl14, this is a good question. As you intuitively seem to understand, it is impossible to make any surgical incision without a scar. The goal, especially in aesthetic surgery, is to make a "fine line" scar, that when mature, is nearly imperceptible. Most qualified/board certified plastic surgeons are extremely meticulous with incision placement, the incision itself, and the incision closure, all of which maximizes chance of getting a discreet, fine line scar. The face also tends to heal very well as compared to other body areas. Additional measures can be taken to help minimize the scars, such as scar creams, silicone gels, scar massage, and sunscreen/avoiding sunlight (especially in the first two years). Assuming the scars do heal well, most people don't notice these scars even when up close, unless they know specifically they are looking for. With that said, if somebody does know what they are looking for and look carefully, they can usually be identified.

Brian K. Machida, MD, FACS · Answer

It's difficult to say how much scarring you will have from your facelift incision. Numerous doctors do precise closures which are hardly visible.  Have you had any other surgeries to compare to?  What is your skin complexion, pigment, skin dry vs. oily? Many factors come into play. It's also good to send pictures to see your hairline for camouflage.

Ronald J. Edelson, MD · Answer

I get very few complaints about the scars. They are well concealed and generally heal quite well. When you go for a consult look carefully at the surgeons photos before making a decision

Derek Fletcher, MD · Answer

The most likely answer is yes. Even perfectly positioned scars that have healed under ideal circumstances can be seen if you look hard enough at conversational distance. However, if your surgeon delivers a natural appearing result and there are no other hints that you had surgery, most people will not notice the because they aren't looking for them.

Connie Hiers, MD, FACS · Answer

Yes, the scars may be visible. If the lighter color is an issue, you can have cosmetic tattooing once healed to improve the color. If scars are a big problem for you, find treatment with radiofrequency instead.