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Recovery GuideUpdated 2026

Pleats Behind Ear After Facelift

Side-by-side comparison of post-auricular incision healing: healthy flat closure on the left vs unwanted bunching pleats on the right

Healthy flat closure (left) vs unwanted pleating/bunching (right) behind the ear after facelift.

Pleats Behind Ear After Facelift: Small tissue folds or pleats behind the ear after deep plane facelift are a normal healing phenomenon that typically resolves within 6-12 weeks. They result from redistributing excess skin during closure and rarely require intervention.

إجابة سريعة

What should I expect with pleats behind ear after facelift?

Recovery varies by individual, but most patients can expect gradual improvement over 2-4 weeks with full results visible at 3-6 months.

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What causes skin pleats or puckering behind the ear after facelift?

Skin pleats or puckering behind the ear after facelift — visible folds or bunching at the post-auricular incision — are a normal early finding during weeks 1–8 as tissue settles and swelling resolves. The skin that was lifted and re-draped needs time to conform to its new position. Most pleats resolve completely by weeks 6–12 without intervention. If puckering persists beyond 3 months, minor scar revision under local anesthesia is a simple, outpatient correction. This is not a complication requiring revision of the main facelift.

Week-by-week recovery timeline

Pleats / standing cones behind the ear

طفيفة — عادة ما تُشفى تلقائيًا

معدل الحدوث
10-25% transient (resolve weeks 4-12)
المدة الزمنية
Visible weeks 1-12
علامات الخطر
  • Pleats persisting beyond month 4 (vs gradually flattening)
  • Pleats that grow firmer or thicker over time
  • Pleats with persistent redness or pain
  • Pleats with overlying scar widening
العلاج القياسي

The vast majority of pleats / standing cones flatten naturally as skin redrapes over months 1-3 — no intervention needed for the first 3 months. Persistent pleats past month 4: in-clinic excision under local anaesthesia (15-20 min, $500-1500/side) or scar revision at 12 months when scars are mature. Aggressive massage in the first 6 weeks is contraindicated — let the redraping happen on its own.

العوامل القابلة للتعديل
  • Excessive skin removal during closure (technique dependent)
  • Tight or uneven skin closure tension
  • Patients with thicker / less elastic post-auricular skin
  • Previous facelift with pre-existing scarring

الوقاية: Surgeon technique is the dominant lever — proper deep plane composite-flap repositioning + meticulous skin redraping at closure minimises pleat formation. Most pleats are technique-related; follow-up at week 4 with surgeon to assess whether intervention is needed.

What Are These Folds Behind My Ear After Surgery?

Pleats behind the ear after a facelift are small folds of skin that can appear along the incision line. This puckering is a normal part of the healing process for about 15-20% of patients and occurs as the skin settles into its new, lifted position. These pleats typically flatten out on their own within 6-12 weeks as healing completes.

  • Pleating is temporary and resolves in 6-12 weeks for most
  • Caused by skin settling after being lifted and redraped
  • Gentle massage after 3 weeks can help smooth the area

Pleats behind the ear after facelift refer to small skin folds or puckering that can occur at the post-auricular incision site during the early healing phase[1]. This is a normal part of recovery and typically resolves within 2-4 months as the tissue settles and the swelling subsides[2]. If persistent pleating and scar concerns remain after 6 months, minor revision under local anesthesia can easily correct it[3].

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Understand pleating and puckering behind the ear after deep plane facelift surgery.

When Do Pleats Resolve?

2-4w

Most Visible

Small skin folds normal at the post-auricular incision. The tissue hasn't settled yet.

2-4m

Resolving

Tissue redistributes and skin smooths naturally. Most pleating disappears without intervention.

6m+

Fully Smooth

If any persist past 6 months, simple minor revision under local anesthesia corrects it easily.

2-3 wks
Initial Recovery
3-6 mo
Full Results
1-2 wks
Peak Symptoms
99%+
Success Rate

Behind-the-Ear Incision Healing Stages

1

Day 1-7

Closure

Sutures in place, peak swelling at day 3, pink line

2

Day 7–10

Sutures Out

Suture removal, scabbing, redness fading

3

Week 3-6

Remodeling

Pleats begin to flatten, color normalizes

4

Month 2-4

Maturation

Scar softens significantly, blends with skin

5

Month 6-12

Final Result

Scar is thin, pale line; virtually invisible

What Should You Expect?

Understanding what to expect during recovery helps patients prepare mentally and physically for the healing process. Deep plane facelift recovery is generally well-tolerated, with most patients experiencing manageable discomfort that improves significantly within the first two weeks.

Your surgeon will provide detailed post-operative instructions tailored to your specific situation. Following these guidelines carefully is essential for optimal healing and results.

Recovery Timeline

Days 1-3
Swelling peaks at days 2–4 (day 3 most common). Most bruising. Rest with head elevated. Take prescribed medications.
Days 4-7
Swelling begins to decrease. May remove drains if placed. Light walking encouraged.
Day 7–10
Sutures removed. Bruising fades. Can usually return to desk work.
Week 3-4
Most social activities can resume. Residual swelling continues to improve.
Month 2-6
Final results emerge. Scars continue to mature and fade.

When to Contact Your Surgeon

Seek Immediate Medical Attention If:

  • • Severe or sudden increase in pain
  • • Excessive bleeding or drainage
  • • Signs of infection (fever, increasing redness, pus)
  • • Difficulty breathing or swallowing
  • • Sudden asymmetry or facial weakness

Frequently Asked Questions

Medical References

  1. 01
    Hamra ST. The deep-plane rhytidectomy. Plast Reconstr Surg. 1990;86(1):53-61(يفتح في علامة تبويب جديدة)(مقالة مجلة)تم الوصول إليه في: 2026-03-21معرف الكائن الرقمي (DOI): 10.1097/00006534-199007000-00008
  2. 02
  3. 03

حقائق أساسية

Pleats behind the ear after facelift are caused by excess skin gathering during wound closure
Post-auricular pleating typically resolves within 3-6 months as tissue settles and remodels
Persistent ear pleats can be corrected with a minor scar revision procedure under local anesthesia

Common Misconceptions

Myth: Pleats indicate surgical error

Fact: Some puckering is normal during healing. It often results from skin adjustment to new contours.

Myth: Pleats are permanent

Fact: Most pleats smooth out within 3-6 months. Persistent issues can be corrected with minor procedures.

Myth: Massage makes pleats worse

Fact: Gentle massage as directed by your surgeon can help smooth pleats. Follow specific instructions.

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