Facelift Incisions - Concerned About Raised Sideburns?

Hello Doctors, I do not want raised sideburns after my facelift. I understand a "double-S" incision along the hairline is performed by some doctors to avoid lifting the sideburns. But, scarring is very noticeable. What is the best procedure in your opinion? If sideburns must be raised, can a hair transplant be performed during the facelift procedure?

Doctor Answers 32

Raised sideburns with facelift

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your are justified in your fear of having raised sideburns.  in my opinion it makes people look like alians.  favor techniques that avoid this.  well placed and closed pre(inter)trichial incisions heal well and the scars can be quite difficult to see. 

Austin Plastic Surgeon
4.9 out of 5 stars 62 reviews

Facelift and invisible incisions

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A modern expertly performed facelift should not have any easily visible incisions. Furthermore, there should not be any hairline distortions in the sideburn or in the back of the ear. It takes experience and talent to place the incisions and then meticulously close the incisions in such a way that even a hairdresser should have difficulties locating these incisions. These goals are not easily achievable by a casual facelift surgeon. Make sure you seek out a facelift expert. Insist on seeing many before and after photos. In our practice we routinely encourage our new patients to observe our postoperative patients when they come in for a routine follow up.

Boris M. Ackerman, MD
Newport Beach Plastic Surgeon
4.8 out of 5 stars 62 reviews

Facelift Incisions - Concerned About Raised Sideburns?

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Short scar, double-S, MACS, etc. facelifts have the common result of keeping the sideburn in its preoperative location. Most of the time, the scars are faint, difficult to see. However, every patient is different and a complete evaluation is necessary before making the decision on which type of facelift is right for you.

If your main concern is the side burn, then the incision along the hairline is the right choice.

Hair transplantation can be done, but in most cases is not necessary with this approach, especially if careful beveling at the hairline has been performed.

I don't recommend hair transplantation at the same time as rhytidectomy.

Good luck.


Kenneth Bermudez, MD
San Francisco Plastic Surgeon
4.9 out of 5 stars 16 reviews

Facelift scars around sideburns

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One of the most noticeable clues to a facelift procedure is elevation of the sideburns. A modern facelift technique will avoid this by positioning the scar in the hairless skin just behind the sideburn hair (you can see this by pulling the hair forward away from the ear). One procedure does not fit all patient's needs, but attention to a tension-free closure and proper scar positioning will avoid noticeable scars and elevation of the hairline no matter what facelift technique is used.

Douglas Leppink, MD
Grand Rapids Plastic Surgeon
4.8 out of 5 stars 27 reviews

Careful Facelift Incision Technique Should Avoid Raised Sideburns Without Need for Hair Transplant

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There are many different approaches to facelift surgery incisions.

The best approach, in my opinion, is to place the superior portion of the incision above the temporal hairline. It is angled in such a way and placed high enough that there is no obvious raising of the sideburns. More importantly, there is no visible scar below the hairline in this region.

An excellent vertical vector to this portion of the facelift can still be carried out with a very natural final result using this approach. This incision can also be connected to an endoscopic brow lift incision if elevation of the brow is desirable at the same time as your facelift surgery.

A hair transplant could be performed at the same time as a facelift procedure, but is generally not necessary.

Michael R. Macdonald, MD
Bay Area Facial Plastic Surgeon
4.6 out of 5 stars 18 reviews

Facelift Incisions

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Thank you for your question. A hair transplant is best after the facelift is performed.  Discuss your concerns with your Board Certified Plastic Surgeon, and there may be options available for you which protect sideburn height. I hope this helps.

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Facelift Incisions - Concerned About Raised Sideburns?

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 I have performed Facelifts for over 25 years and the sideburns do not need to be raised.  It's all a matter of where the incisions are placed and the vector of tissue elevation inside the facelift area of dissection.  If you are a male, the sideburns will come closer to the front of the ear but most men have to shave that area anyway and none have complained.  If you are a female, the tuft of hair in front of the ear will remain as I do not extend the facelift incision into the temple hairline in facelifts.  In my opinion, that portion of the incisions is not necessary.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Raised Sideburns After Facelift

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I use incisions that follow the horizontal hairline (sideburn hairline) so that I am not removing any hair and not changing the hairline.  If the incisions are placed properly in front of the ear and behind the ear, the hairline will not be changed at all.  If a patient has had surgery that raised the hairline, then hair transplants can be done to correct this.  

Jonathan Pontell, MD, FACS
Philadelphia Facial Plastic Surgeon
4.8 out of 5 stars 113 reviews

Facelift Incision to Avoid Raised Sideburns

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Use of the sideburn-sparing incision, where essentially a horizontal incision is made just along the bottom edge of the sideburn, is able to save the sideburns.  This is my preferred technique, because of its significant advantage.

Jeffrey Epstein, MD, FACS
Miami Facial Plastic Surgeon
4.7 out of 5 stars 145 reviews

Preserving the hairline with facelifts

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Your surgeon should discuss with the options for incision placement: by interdigitating the incision with the hair follicles along the hairline, you can preserve hair and obtain a very natural result. Hair transplant can always be done to correct poor results, but should be rarely needed.

Roy A. David, MD
San Diego Facial Plastic Surgeon

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.