Pre-Auricular Incision in Deep Plane Facelift

A pre-auricular incision is the front-of-ear segment that runs in the natural skin crease between the cheek and the ear. It begins at the temporal hairline above the ear, follows the curve down past the tragus, wraps under the earlobe, and continues behind the ear into the post-auricular crease. It's one of the three core segments of any facelift incision — the others being the temporal hairline (above the ear) and the post-auricular (behind the ear). Some surgeons place the front-of-ear portion inside the tragus cartilage (retro-tragal) to conceal it, while others use the pre-auricular crease; we hold no study that compares how visible the two scars become.

A trichophytic (Greek for 'hair-loving') incision is bevelled at an angle so that hair follicles can grow up through the scar after healing. A straight incision cuts perpendicular to the skin, so hair grows up to the scar but not through it. Surgeons use the trichophytic design at the temporal segment of the pre-auricular line and for the sideburn-preserving section, and straight incisions are still used in revision cases or where the prior scar is already straight. We hold no study that compares how visible the two scars become, so ask your surgeon which design they use and why.

Sideburn preservation matters because aggressive lifting can shift the hair-bearing skin upward and backward, leaving a smaller and elevated sideburn. The fix is technique-dependent: the surgeon plans the incision so that lifting vector is vertical (true deep plane, not skin-only), trims skin conservatively, and where needed adds a horizontal-relaxing incision to preserve the natural sideburn position. Asking to see the surgeon's own before and after photos at month 6 or later, with attention to sideburn position, is one way to check. We hold no study of how often the sideburn shifts, so your surgeon's own cases are the evidence available.

Weeks 1-2: pink line under steri-strips, sutures come out at day 7-10. Weeks 3-6: line remains pink but flattens; silicone gel and sun protection begin as your surgeon directs. Weeks 6-12: scar continues to flatten, redness fades from bright pink to soft pink. Months 3-6: scar shifts from pink to skin tone; this is the slowest phase of visible improvement. Months 6-12: maturation into a shadow line that follows the natural cheek-ear crease. These are typical ranges from surgeons' practice, not measurements, and how visible your scar becomes is for your surgeon to show.

How visible a pre-auricular scar becomes has not been measured in a way that supports a figure, and we found no study of it. Surgeons point to three things that bear on it: the surgeon's technique, how the scar is cared for, and the patient's own skin type, since darker skin can develop hyperpigmentation if the scar is not protected from the sun. Ask your surgeon to show their own cases at each milestone, and see our before-and-after gallery.