36, 2 years post facelift - What can be done about this scarring? (Photos)

Question

I got Face lift 2 years ago. I deeply regret it. But now I’m left with scarring behind the ears. What can be done about this? Especially the one where it looks taut and ruched.… please assist. Thanks. I’m 36.

Frank Agullo, MD · Answer

At two years out, scars are fully healed and, as a result, stable enough for revision. The tightness and bunching behind your ear is likely skin that was closed under slightly too much tension, forming pleats rather than lying flat along the postauricular sulcus. A hypertrophic band often forms within the pleats along the sulcus. Scar revision addresses the issue by removing the scar itself, relaxing the tension.

#StayBeautiful,

@RealDrWorldWide

#StayBeautiful,

@RealDrWorldWide

Anna Chacon, MD, FAAD · Answer

At 2 years post–facelift, scars are fully mature, so improvement is still very possible—but requires targeted treatment based on the type of scar. From your description (“taut” and “ruched”), this sounds like a combination of hypertrophic scarring and tension-related distortion, sometimes seen behind the ears after facelift closure.

For thick, raised, or firm scars, first-line options include intralesional corticosteroid injections (often a series), which help flatten and soften the scar over time. Silicone gel or sheeting can also improve texture and redness with consistent use.

For texture irregularity or visible ridging, laser resurfacing (fractional or pulsed dye laser) or radiofrequency microneedling can significantly smooth the scar and improve color mismatch. These are especially helpful when the scar looks “ruched” or uneven.

If the scar appears pulled, tight, or distorted, this suggests residual tension or a structural issue (sometimes related to “pixie ear” changes). In these cases, the most definitive option is surgical scar revision, where the scar is carefully re-excised and re-closed with better tension control. This does not erase the scar, but can make it far less noticeable.

Most patients benefit from a combination approach—for example, steroid injections followed by laser, or revision surgery with postoperative scar optimization.

Even at 2 years, meaningful improvement is very achievable with the right strategy.

36, 2 years post facelift - What can be done about this scarring? (Photos)

Answers (2)

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