Is it inevitable that facelift scars will stretch over time?

If facelift incisions are done properly and carefully, and not sutured under tension, will they be OK over time (years)? Or is it inevitable that they will stretch and widen regardless of technique? Thank you.

Doctor Answers 17

Facelifting #woundhealing #cosmeticsurgery #BOTOX

Dear heartease

Thank you for your question!  The incisions/scarring generally mature at 3 to 6 months after surgery and continue to face up to a year.

They will not change much after that point.  If there is a lot of tension on the closure- there will be changes in the scars early after surgery- they will drift down and spread and possibly thicken.

With Warm Regards

Trevor M Born MD


Toronto Plastic Surgeon
4.9 out of 5 stars 109 reviews

Will facelift incisions invariably widen.

Facelift incision become visible because a number of factors with tension being one of them.  If an incision is placed under tension it can widen and thicken over time.

Another cause of visible incisions is their placement.  When incisions are placed in hair-bearing regions they may result in alopecia, creating the appearance of a wider scar.  These incision may also distort the hairline, causing more visible scarring.

Since the incisions are hidden around the ears they can distort them by pulling on the lobe, the tragus (bump in front of your ear canal opening) and creating a color change.

Not all incisions will heal ideally, but care should be taken in closing these incisions.

Most of the time they are difficult to notice as time passes.  

Discuss these concerns with your Specialist.

Ernest Robinson, MD
Aliso Viejo Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

FACE LIFT SCAR STRETCHING

Facelift scar widening should be very rare.  The areas of tension should be well hidden and the skin itself should be very relaxed at the suture line.  Stretching of the skin/scar itself, is therefore uncommon.  If you have that issue, you should bring it up to your surgeon and have the scars revised.

R. Scott Yarish, MD
Houston Plastic Surgeon
4.4 out of 5 stars 34 reviews

Stretching is possible, but not inevitable.

Facelift incisions should be placed in natural curves in front of the ear. Behind the ears, the incisions are usually straight. All of the incisions should be placed under minimal tension. Behind the ears, there is sometimes bunching of excess skin, and this can lead to scars that might heal in a way that's slightly more noticeable than those in front of the ear. Stretching is not inevitable, though, and it may be a result of the technique used to close the wounds.

Face lift scars - do they always widen?

Thank you for asking about your face lift scars.

  • The face lift scars that are in front of the ears should heal with a fine line that is ultimately unnoticeable.
  • The ones behind the ears do tend to widen and shift downward - to some extend.
  • Because of where they are placed, they are rarely visible. 
  • Always see a Board Certified Plastic Surgeon.
Best wishes - Elizabeth Morgan MD PHD FACS

Quality of face-lift scars - incision placement and conservative skin excision are key!

Hi there. Thanks for your question. You seem to already be familiar with the basic tenets of good wound healing and fine scar formation. There is obviously a genetic component to the final scar formation, which cannot be accounted for surgical technique. However, there are several manoeuvres that are fundamental to good scar formation. Placement of the incision is critical to producing well-concealed inconspicuous scars. Another key issue is avoidance of excessive skin - this used to be a favoured approach to lifting the face but modern techniques do not rely on skin removal at all. With a conservative skin excision, the two wounds line up without tension and the resultant scar should not stretch over time. Good luck!

Facelift incisions

Ideal facelift incisions are well-camouflaged in hair-bearing areas and natural creases between face, ear, and neck.  Ideal scars are also narrow and close in color and texture to surrounding skin.  Once healed completely, scars typically do not change much.  An unsatisfactory scar can typically be improved with time, steroid injections, laser, or surgical revisions, among other options.  

Inessa Fishman, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 1 review

Facelift Scar Appearance- Is it technique dependent?

Heartsease,

Regardless of the technique used, well placed scars that are sutured without tension should be almost imperceptible after a full course of healing.  Vigilant care of the scar lines for a full year after the procedure including skin hydration and UV protection are key to optimizing your result.  

In a minority of people, genetic factors or inherent qualities of the skin may predispose someone to potential wound healing issues or more significant scarring. Scars on other parts of the body may be an indication of how the facelift incisions will heal/look, but should not be considered absolute representations of the final scar.

Discussion of post-operative scar care and thorough evaluation for potential scarring issues should be part of the pre-operative consultation and planning.

Daniel Beck, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 20 reviews

Facelift scar stretching is not inevitable.

Facelift incisions, if placed correctly and closed with minimal tension and meticulous technique, should not stretch or widen.  Some exceptions to this are patients with skin conditions or genetic factors which may alter normal wound healing. Your plastic surgeon and discuss this in detail with you.

Facelift incisions

Positioning the skin without tension combined with proper technique during incision closure will prevent stretching over time. Over course, there is a small percentage of patients who, either due to health conditions or family history, may not have ideal wound healing but this is independent of surgical technique. Be sure to ask for before and after photos from your surgeon during initial consultations to get an idea of how patients recover over time. Good luck!

Mark Been, MD
Barrington Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.