Pleats Behind Ear After Facelift
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.
Quick Answer
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.
Source: DeepPlane.com · Reviewed
Pleats / standing cones behind the ear
Minor — usually self-resolves
- •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
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.
- •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
Prevention: 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.
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].
Understand pleating and puckering behind the ear after deep plane facelift surgery.
When Do Pleats Resolve?
Most Visible
Small skin folds normal at the post-auricular incision. The tissue hasn't settled yet.
Resolving
Tissue redistributes and skin smooths naturally. Most pleating disappears without intervention.
Fully Smooth
If any persist past 6 months, simple minor revision under local anesthesia corrects it easily.
Behind-the-Ear Incision Healing Stages
Day 1-7
Closure
Sutures in place, peak swelling at day 3, pink line
Day 7–10
Sutures Out
Suture removal, scabbing, redness fading
Week 3-6
Remodeling
Pleats begin to flatten, color normalizes
Month 2-4
Maturation
Scar softens significantly, blends with skin
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
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
- 01Hamra ST. The deep-plane rhytidectomy. Plast Reconstr Surg. 1990;86(1):53-61(opens in new tab)(Journal Article)Accessed: 2026-03-21DOI: 10.1097/00006534-199001000-00006
- 02Barrera A. Refinements in the deep-plane facelift technique. Plast Reconstr Surg. 2000;105(1):290-301(opens in new tab)(Journal Article)Accessed: 2026-03-21DOI: 10.1097/00006534-200001000-00047
- 03American Society of Plastic Surgeons - Facelift Statistics 2024(opens in new tab)(Organization)Accessed: 2026-03-21
Key Facts
Related Recovery Topics
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.
Receive the Dispatch
Join 12,000+ readers — monthly research updates, surgeon spotlights, and patient guides. Unsubscribe anytime.
You Might Also Like
Dr. Yakup Duman
Plastic, Reconstructive & Aesthetic Surgery Specialist
Board-certified Plastic & Aesthetic Surgery specialist with 13+ years of experience. Specializes in deep plane facelift at Merkez Prime Hospital, Istanbul. Medical Reviewer for DeepPlane.com.
Turkish Plastic Reconstructive and Aesthetic Surgery Association