I am a 57 year old, white, female with blond hair and am considering a facelift. Where is the best outcome as far as scar placement?

Dr A’s Answer:
At 57, there is generally not much role for any sort of short incision facelift. Typically the incision will start in the temple area, extend down in front of the ear, closely following the natural curve of the ear, tuck in behind the tragus (piece of cartilage in front of ear canal), and then out in front of the ear again tightly hidden in the crease between the earlobe and cheek. From there it will wrap around into the crease behind your ear. After continuing in the crease behind the ear close to the top, I I bring the incision across the narrow area of skin to the edge of the hairline. I follow the hairline down a bit and then gently curve it into the hair hiding the rest of it within the hair.

Key points:

  1. Lift the face with the deep tissue, not the skin. Extra skin is removed in a more back direction and is not used to hold the face up. Should the surgeon move the skin up, you will have a bald patch above the front of the ear. Moving skin up also brings neck skin onto your lower facelift which doesn’t look normal and can cause the “swept look”.
  2. Gently curve the incision behind the ear into the hairline. I mostly see other surgeons go straight into the hair resulting in a deformity of the hairline. This creates a sharp step-off which is obvious and prevents you from pulling your hair back. Gently curving the incision results in a normal hair line.
  3. The scars in front of the ear heal very well on almost everyone provided they were closed meticulously. Some individuals, mostly because of genetics, form less perfect scars behind the ear. It is hard to know who those people are before surgery.