Which is better - incision in the hairline or just below the sideburn for lower facelift?

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

I use both incisions. If I anticipate a larger amount of skin to be removed I will use the sideburn to avoid moving it (not a good look) but if the amount of the skin is less I do the hairline incision.

Although these days I almost always place my incision just at the temporal hairline, it should be understood that there are advantages and disadvantages to either approach. The reason for my decision is that I place zero tension on the skin at this location and it allows for stabilization of the temporal hairline, without raising it; I can't remember the last time I had to revise a scar in this area. The advantage of the incision into the temporal hair is that it is theoretically hidden, although I have seen many examples when it wasn't, likely due to excess skin tension at closure. The disadvantages are that this incision removes hair bearing temple, thereby raising the temporal hairline. This can be acceptable for some people, but a bad idea for the high-average temporal or male hairline. However, I have done both in my career and incision appearance is really more about the quality of the Surgeon.

Traditional incisions that were placed behind the temporal tuft in the hair line hide well, but tend to pull the sideburn into the scalp and can give a very "operated" look. Most current surgical techniques use an incision that follows the sideburn a few hair follicles in. While these can be visible upon close inspection, with a good closure technique involving no/minimal tension and proper suture placement the scars can be almost invisible. This is a question that you should ask your surgeon and be comfortable with prior to surgery. I like to show pictures of cases and exactly what the incisions look like during consultations.

This is the exact reason I prefer hiding this incision within the hair itself rather than along the hairline- so hair can be worn up in a ponytail without exposing the scar. This incision does not involve the sideburn, it goes from the scalp hair along the creases of the ear to keep the incisions as hidden as possible

Incisions can be placed in a couple of different locations depending upon your anatomy and the amount of loose skin. Please discuss this with your surgeon.