Temporal Hairline Incision in Deep Plane Facelift
Temporal hairline incision follows the natural hair shadow line and is concealed by surrounding hair.
Temporal Hairline Incision: The temporal hairline incision is the upper segment of the facelift cut, running along or inside the temple hairline above the ear. It's the most visible portion of the incision and the highest-leverage zone for trichophytic technique. Hairline shift in 10-15% of cases is the main technique-dependent risk.
Quick Answer
What is the temporal hairline incision and why does it matter?
The temporal hairline incision is the upper segment of the facelift cut, running along the temple hairline above the ear. It's the most visible portion of any facelift scar because hair density at the temple is naturally lower than the rest of the scalp. Two design choices: hairline incision (along the hair-skin border, preserves natural shape but visible if scar is straight) or temporal scalp incision (deeper inside the hair, hidden but can shift the hairline upward). Trichophytic bevel technique allows hair to grow through the scar and is the modern default. Hairline shift occurs in 10-15% of cases when lift vector is skin-dominant rather than structural.
Source: DeepPlane.com · Reviewed
Temporal hairline shift
Moderate — clinical management often needed
- •Hairline visibly higher than pre-op photos at month 3+
- •Asymmetric hairline comparing left vs right
- •Temporal area appears bald or sparse compared to pre-op
- •Visible widow's peak / receded temple shape change
Mild shift often improves over months 3-6 as residual swelling resolves. Persistent shift at 12 months: a small horizontal hairline-relaxing incision can restore some position; severe loss may require follicular unit transplantation (FUE) into the new hairline position. FUE typical cost $3-6K; outpatient, no downtime. Acceptance + styling (side-swept fringe, headbands) is the most common path for mild cases.
- •Skin-only lift vector (not true deep plane structural)
- •Excessive vertical pull at the temporal segment
- •Pre-existing high or thin temporal hairline
- •Female-pattern temporal recession not noted pre-op
- •Aggressive skin trimming at closure
- •Revision cases with prior temporal incision
Prevention: True deep plane composite-flap repositioning lifts at the structural level so overlying skin redrapes naturally without dragging the hairline up. Conservative skin trimming. Hairline-incision (vs scalp-incision) placement preserves natural shape. Pre-op photo markup of temporal hairline position; intraoperative comparison of left-vs-right symmetry; review surgeon before/after gallery specifically for hairline position at month 6+.
The temporal hairline is the most visible portion of any facelift incision because hair density and follicle pattern at the temple are naturally lower than the rest of the scalp. Even a perfectly executed scar shows more here than at the pre-auricular crease or behind the ear, because there's less hair to disguise it. This makes the temporal segment the highest-leverage zone for technique decisions: trichophytic bevel, hairline-vs-scalp placement, and the choice between full temporal vs short-scar all matter most here.
- Hair density at the temple is naturally lower
- Trichophytic bevel is the highest-impact technique here
- Lift vector dictates whether the hairline stays in position
- Some patients are better served by short-scar, skipping this segment
The temporal hairline incision is the upper segment of any deep plane facelift cut and the most visible portion because hair density at the temple is naturally lower than the rest of the scalp[1]. Modern technique uses a trichophytic bevel — a 30-45° angled cut that allows hair follicles to grow up through the healing scar, hiding the line[2]. Hairline shift occurs in roughly 10-15% of cases when the lift vector is skin-dominant rather than structural; true deep plane composite-flap repositioning preserves natural hairline position in over 85% of patients[3]. Where temporal hairline shift risk is elevated (high pre-existing recession, thin hair, female-pattern temporal thinning), some surgeons opt for a short-scar approach that omits this segment entirely.
Where the Temporal Incision Sits
Temporal Healing Stages
Days 1-7
Closure
Sutures in, no hair wash, pink line
Weeks 1-2
Suture Removal
First hair wash, no heat styling
Weeks 2-8
Hair Regrowth
Trichophytic follicles emerge through scar
Months 3-6
Filling In
Scar fades, hair fills temporal zone
Months 6-12
Final
Hairline transition virtually invisible
Hairline vs Scalp Incision Placement
Two competing placements exist for the temporal segment, each with distinct trade-offs:
Hairline incision (modern default)
- Cut runs along the hair-skin border
- Preserves natural temporal hairline shape
- Scar visible at hairline edge if not trichophytic
- No upward shift of the temporal hair-bearing zone
- Best for patients with full / typical hair density
- Pairs well with trichophytic bevel
Temporal scalp incision
- Cut placed deeper inside hair-bearing scalp
- Scar fully hidden under hair
- Risk: temporal hairline shifts upward with the lift
- Used historically and in some traditional schools
- Avoid in patients with thin / receded hairlines
- Less common in modern deep plane technique
Most modern deep plane surgeons default to a hairline-incision-with-trichophytic-bevel combination. This preserves the natural temporal hairline position while allowing hair to regrow through the scar to disguise the line.
When Surgeons Choose Short-Scar
Short-scar (or limited-incision) facelift omits the temporal hairline segment entirely, beginning the incision at or just above the ear. It's appropriate for selected patients:
- Limited mid-face / upper-cheek laxity: early signs of aging, typically patients in their 40s where the deep plane lift is mostly addressing jowls and neck rather than upper cheek descent.
- High or already-recessed temporal hairlines: the standard temporal incision risks worsening the recession; skipping it preserves what's there.
- Fine, thin hair where any temporal incision is hard to hide: short-scar avoids creating a visible line in a low-density zone.
- Thin facial skin: extensive dissection adds disproportionate risk of skin necrosis or visible scar in this anatomy.
- Prior temporal incision being revised: avoiding a second cut in the same zone reduces hairline shift compounding.
Limitations: short-scar techniques have less ability to address heavy mid-face descent and cannot fully redrape the upper cheek. Patients with significant laxity (typically late 50s-70s) usually need the full temporal incision to achieve an adequate result.
The trade-off is scar visibility (lower with short-scar) versus completeness of lift (higher with full temporal). Discuss your specific anatomy in pre-op consultation — your surgeon should be able to articulate why they're choosing one over the other for you.
Hair-Care Rules During Healing
- No hair dye, bleach, or chemical relaxers within 2 cm of the incision until at least week 6. Chemicals can disrupt the still-fragile follicle regrowth from the trichophytic bevel and cause patchy regrowth.
- No heat styling tools (curling irons, flat irons, blow dryers on hot setting) over the area for 4-6 weeks. Heat slows healing and can damage emerging hair follicles.
- Daily mineral SPF 50 along the entire scar line for at least 6 months. UV exposure on a fresh scar causes long-term hyperpigmentation that's very difficult to reverse.
- Gentle hair washing only with sulfate-free shampoo for the first 3 weeks. Strong surfactants can irritate the wound and disturb early follicle regrowth.
- No tight ponytails, headbands, or hats with rigid edges that put sustained pressure on the temporal area for the first 4-6 weeks. Pressure can cause widening or asymmetric scar maturation.
- Avoid styling against the bevel direction. Brush in the direction of natural hair growth so emerging follicles aren't pulled the wrong way.
For more on hair-related concerns post-surgery, see our facelift hair loss guide and the pre-auricular incision page.
When to Contact Your Surgeon
Reasons to call promptly:
- • New redness, warmth, or pus along the temporal scar
- • Wound dehiscence (separation)
- • Visible hairline shift worsening past month 3
- • Patchy hair regrowth or visible bald patch at the scar at month 4+
- • Hypertrophic ridge / thickening at month 2-3 (treatable with silicone sheets or steroid injection)
- • Persistent pink/red colour past month 6 (may benefit from pulsed-dye laser)
- • A retained suture surfacing at week 3+
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
- 03Mendelson BC, et al. Surgical anatomy of the midcheek and malar mounds. Plast Reconstr Surg. 2002;110(3):885-896(opens in new tab)(Journal Article)Accessed: 2026-03-21DOI: 10.1097/00006534-200209010-00001
Key Facts
Common Misconceptions
Myth: A scalp incision is always better hidden than a hairline one
Fact: Scalp incisions hide the scar but can shift the hairline upward with the lift. Modern deep plane prefers hairline-with-trichophytic-bevel for natural shape preservation.
Myth: Short-scar always means lesser results
Fact: For patients with limited upper-cheek laxity (typically 40s) or high pre-existing hairlines, short-scar produces equivalent results with less scar burden. It's a selection question, not a quality question.
Myth: Hair never grows back through a facelift scar
Fact: A trichophytic-bevel temporal incision allows transected follicles to grow up through the scar. Full hair regrowth typically takes 4-6 months. Non-bevelled (perpendicular) cuts do not allow this — bevel design is the key.
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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