Scarring After Deep Plane Facelift
Hypertrophic / keloid scarring
Умеренная — часто требуется клиническое вмешательство
- •Scar continues raising past month 2
- •Scar grows BEYOND the original incision boundary (keloid)
- •Scar is itchy, painful, or persistently red after month 3
- •Scar feels firm or rope-like at month 4+
First-line: silicone gel/sheets daily for 12 weeks (only OTC product with consistent meta-analysis evidence — Mustoe TA 2002, Cochrane 2013). Second-line: intralesional triamcinolone injections every 4-6 weeks for hypertrophic scars. Third-line: pulsed-dye laser for vascular component, surgical revision after 12 months for resistant keloids. Fitzpatrick IV-VI: pre-op hydroquinone protocol reduces post-inflammatory hyperpigmentation.
- •Fitzpatrick IV-VI skin type (5-15× elevated risk)
- •Personal or family history of keloid
- •Tension at incision closure
- •UV exposure on healing scars (causes pigment changes)
- •Chronic incision irritation (helmet straps, glasses arms)
Профилактика: Tension-free closure technique by surgeon, trichophytic incision technique, silicone gel/sheets weeks 2-12, mineral SPF 50+ on incision lines for 6 months minimum, skin-of-color protocol with pre-op hydroquinone 4% + tretinoin for Fitzpatrick IV-VI patients.
Быстрый ответ
Will I have visible scars after a deep plane facelift?
Deep plane facelift incisions are placed inside natural skin folds — behind the tragus, around the earlobe, in the post-auricular crease, and along the hairline. Scars take 12–18 months to fully mature but are nearly invisible at conversational distance for most patients. Abnormal scarring (hypertrophic or keloid) affects fewer than 2% of patients.
Источник: DEEPPLANE™ ·
Where are facelift scars located and are they visible?
Deep plane facelift scars are placed in five concealed zones: inside the tragus (the small cartilage bump in front of the ear canal), around the earlobe, in the post-auricular crease behind the ear, along the lower scalp/hairline, and in the submental (chin) crease for neck work. Fresh scars are pink and visible at 4–8 weeks; by 6 months they fade to a skin-tone white line; by 12–18 months they are nearly invisible at normal conversational distance. Fewer than 2% of patients develop hypertrophic or keloid scarring. Key risk factors for poor scarring: smoking, diabetes, darker Fitzpatrick skin types (IV–VI), and excessive tension on the closure.
Any surgical incision creates a scar — this is unavoidable. The art of facelift surgery lies in placing those incisions where they are least noticeable: within the ear anatomy, behind the ear, and blended into the hairline. Skilled surgeons close wounds in multiple tension-free layers so surface skin has minimal tension, which is the most important determinant of scar quality.
- All facelift incisions scar — placement determines visibility
- 12–18 months for full maturation
- Abnormal scarring affects fewer than 2% of patients
The concern about facelift scars is understandable — but the reality is that most patients are surprised by how well-hidden their incisions become[2]. Surgeons who specialize in deep plane facelift place meticulous attention on incision design, tension-free closure, and closure in layers[3,4]. Understanding your incision care routine and the normal recovery timeline helps set accurate expectations[5]. For context on the overall procedure, see what a deep plane facelift involves.
Facelift Scar: A facelift scar is the permanent but typically inconspicuous mark left by surgical incisions made during a deep plane facelift. Incisions are strategically placed inside the tragus, around the earlobe, in the post-auricular crease, and along the temporal hairline. With proper wound care and sun protection, most scars are nearly invisible by 12–18 months.
— DEEPPLANE™ Expert Panel
Scarring After Facelift: Quick Facts
- Scar Maturation
- 12–18 months
- Hypertrophic Rate
- <2% of patients
- Keloid Rate
- <0.5% of patients
- Best Prevention
- Sun protection + silicone
- Treatment Options
- Silicone, laser, steroid
- Incision Placement
- Tragal, post-auricular, hairline
Источник: Clinical Studies & The Aesthetic Society
Where Are Facelift Incisions Placed?
Tragal Incision
Runs inside the front edge of the tragus (the small cartilage in front of the ear canal). Hidden in the natural shadow of the ear and virtually invisible at conversational distance.
Post-Auricular Incision
Follows the natural crease behind the ear and onto the mastoid (hairless skin behind the ear). Well hidden and typically the most inconspicuous facelift scar location.
Temporal / Hairline Incision
Runs within or just behind the temporal hairline above the ear. Hair growth naturally camouflages any residual scar. The surgeon's technique determines whether the hairline is preserved or shifted.
Scar Maturation Timeline
Weeks 1–4: Acute Healing Phase
Incisions appear pink–red and may be slightly raised. Sutures are removed at 5–10 days. Some crusting along the wound line is normal. Keep incisions clean and out of direct sun.
Months 2–4: Remodelling Phase
Scars may temporarily thicken, darken slightly, or itch as collagen reorganises. This is normal. Begin silicone gel application as directed. Avoid sun entirely — UV exposure causes permanent pigmentation changes in healing scars.
Months 4–9: Progressive Fading
Most scars are noticeably flatter and paler. Redness reduces month by month. Makeup can fully camouflage any remaining discoloration from 4–6 weeks post-op onward.
Months 12–18: Mature Scar
Final scar appearance. For most patients: a fine pale line in a natural crease, invisible unless specifically searched for. Residual hypertrophy, if present, typically responds well to steroid injections at this stage.
Types of Abnormal Scarring
What can go wrong and who is at higher risk
Hypertrophic Scar (<2%)
Raised, red, stays in wound boundary. Responds well to silicone + steroids.
Keloid Scar (<0.5%)
Extends beyond wound edges. Higher risk in darker skin types. Recurs after treatment.
Widened / Stretched Scar
Flat but wide. Caused by tension at closure. Correctable with scar revision at 12 months.
Pigmented Scar (PIH)
Darkening from UV exposure. Prevented by strict sun protection. Laser treatment available.
Patients with Fitzpatrick skin types IV–VI or a personal/family history of keloids should discuss this with their surgeon before proceeding
Treatment Options for Prominent Facelift Scars
Silicone Gel Sheets or Topical Silicone
First-line, highest-evidence treatment. Worn 12 hours per day for 3–6 months. Occlusion and hydration reduce collagen overproduction. Both sheet and gel forms are equally effective.
Intralesional Steroid Injections (Triamcinolone)
3–5 sessions spaced 4–6 weeks apart. Highly effective for hypertrophic scars. Can cause skin thinning or hypopigmentation if overdosed — requires an experienced injector.
Pulsed-Dye Laser (PDL) or Fractional Laser
PDL targets redness and vascular components. Fractional laser improves texture and blends scar margins. Both are useful for scars that are flat but discoloured. Treatments begin at 8–12 weeks post-op.
Surgical Scar Revision
For severely widened, malpositioned, or keloidal scars. Best deferred until 12–18 months of full scar maturation. A short procedure under local anaesthesia re-excises the scar with optimised closure technique.
Who Is at Higher Risk of Abnormal Scarring?
- Fitzpatrick skin types IV–VI (darker skin tones) — higher melanocyte activity increases post-inflammatory pigmentation and keloid tendency
- Personal or family history of keloids — genetic predisposition is the strongest risk factor
- Smokers — impaired wound healing raises hypertrophic scar risk
- Patients who develop wound dehiscence or infection — heals by secondary intention, producing wider scars
- Patients with tension at closure — often related to over-aggressive skin excision; highly technique-dependent
Your Questions Answered
Medical References
- 01Hamra ST. The deep-plane rhytidectomy. Plast Reconstr Surg. 1990;86(1):53-61(открывается в новой вкладке)(Статья в журнале)Доступ получено: 2026-03-21DOI: 10.1097/00006534-199001000-00006
- 02Baker DC. Complications of cervicofacial rhytidectomy. Clin Plast Surg. 1983;10(3):543-562(открывается в новой вкладке)(Статья в журнале)Доступ получено: 2026-03-21
- 03Grover R, et al. The efficacy of postoperative management in facelift surgery. Aesthet Surg J. 2015;35(5):NP124-NP131(открывается в новой вкладке)(Исследовательская работа)Доступ получено: 2026-03-21DOI: 10.1093/asj/sjv053
- 04Marchac D, et al. Skin slough after face-lifting. Plast Reconstr Surg. 1999;103(2):554-560(открывается в новой вкладке)(Статья в журнале)Доступ получено: 2026-04-13DOI: 10.1097/00006534-199902000-00017
- 05NIH National Library of Medicine - Rhytidectomy StatPearls(открывается в новой вкладке)(Правительственный источник)Доступ получено: 2026-04-01
Ключевые факты
Common Misconceptions
Myth: Facelift scars are always visible
Fact: Expert-placed incisions in natural skin folds and the hairline are nearly invisible at conversational distance once mature. Most patients cannot see their own scars unless using a mirror specifically designed to view behind the ear.
Myth: If my scar looks bad at 3 months it will always look bad
Fact: Scars at 3 months are still actively remodelling. The 3-month mark often represents peak redness and firmness. Most continue to improve significantly through the 12–18 month mark.
Myth: Sun exposure helps scars fade faster by tanning
Fact: UV exposure is the most preventable cause of permanent scar darkening (post-inflammatory hyperpigmentation). Always apply SPF 50+ to healed incisions for at least 12 months.
Essential Considerations
Surgeon experience and technique are the biggest determinants of scar quality
Begin silicone gel as soon as incisions are fully closed (typically 2–3 weeks)
SPF 50+ sunscreen on scars every day for 12 months — even on cloudy days
Do not judge your scar outcome before 12 months of full maturation
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Dr. Yakup Duman
Специалист по пластической, реконструктивной и эстетической хирургии
Сертифицированный специалист по пластической и эстетической хирургии с более чем 13-летним опытом. Специализируется на подтяжке лица deep plane в Merkez Prime Hospital, Стамбул. Медицинский рецензент DEEPPLANE™.
Турецкая ассоциация пластической, реконструктивной и эстетической хирургии