A facelift requires incisions, and every incision creates a scar. The aim is to place scars thoughtfully, close them without excessive tension and guide healing so they become as discreet as possible.
Scar quality differs between patients and depends on incision design, tissue handling, skin tension, wound care and individual healing.
Where are the incisions placed?
The pattern is adapted to the hairline, sex, hairstyle, anatomy and amount of skin that must be redraped. A typical incision may begin within the temporal hair or along the sideburn, follow the natural contours in front of the ear, pass around the earlobe, continue into the crease behind the ear and finish within or along the posterior hairline.
If the neck needs direct treatment, a short incision may be placed in the crease beneath the chin. Limited procedures may use shorter incisions, but a shorter scar does not automatically mean a better result. Access must be sufficient for the correction required.
Why incision design matters
Planning should preserve the sideburn, tragus, earlobe and hairline. Poor design or excessive skin tension can distort these structures or pull the earlobe downwards.
Deeper tissues should provide structural support. The skin can then be redraped and trimmed conservatively. A low-tension closure supports a natural appearance and may improve scar quality.
How scars change
During the first weeks, incisions may look pink, red or slightly raised. Firmness, numbness and small crusts can occur. Over the first few months, redness generally settles, although a scar may temporarily become firmer before improving. Sensation around the ears and hairline can remain altered.
Over many months, scars usually soften, flatten and fade. Their final colour and texture cannot be judged early. Some patients heal with very fine lines, while others naturally develop wider, darker, lighter or raised scars.
What affects scar quality?
Important factors include genetics, skin type, nicotine exposure, diabetes, infection, bleeding, wound separation, sun exposure, excessive tension and adherence to care instructions. Patients should report any history of hypertrophic or keloid scars.
Incision planning may differ for men because beard-bearing skin should not be moved unnaturally close to the ear. Hair thinning and hairstyle preferences also influence scar placement.
Scar care
Early care focuses on cleanliness, protection from trauma and monitoring. Later, selected patients may be advised to use silicone, massage or another treatment. Timing must come from the surgeon.
Sun protection matters because ultraviolet exposure can prolong redness or pigmentation. Make-up, hair colouring, active skincare and energy-based treatments should not touch healing incisions until approved. Patients should not pick crusts or apply unapproved creams.
When should a scar be reviewed?
Contact the team if an incision becomes increasingly red, hot, painful or swollen; produces abnormal drainage; separates; bleeds; or develops marked colour change. Later review is appropriate if a scar remains thick, raised, itchy, wide or unusually pigmented.
No surgical facelift is truly scarless. The realistic goal is a carefully positioned, well-supported and progressively fading scar—not a promise that no scar will exist.
Op. Dr. Oğuz Kılıç
Plastic, Reconstructive and Aesthetic Surgeon
