Patients considering a facelift ask about scars in a particular way. They ask whether the scars will show, expecting the answer to be about the quality of healing, and the honest answer is that healing is the smaller half of it. Facial incisions are placed along borders where the eye already expects a change of texture, so a scar in the right place is genuinely difficult to find once it has matured.

What people do notice is something else. When somebody looks like they have had a facelift, it is rarely because a line beside the ear is visible. It is because an earlobe sits wrong, or a sideburn has moved, or the hairline in front of the ear has climbed. Those are the outcomes worth understanding before surgery, because unlike a scar they cannot be waited out.

Where the incisions actually run

A facelift incision traces the ear rather than crossing the face. It typically starts in the temple hair or at the leading edge of the sideburn, comes down in front of the ear, passes around or under the earlobe, then turns upward behind the ear and ends within the hair at the back of the scalp.

Laid out that way, most of its length is either inside hair or pressed against an edge the eye already reads as a boundary. That is the whole design principle. A scar sitting on the cheek would be conspicuous at any quality of healing, and a scar following the ear can be nearly invisible at ordinary distance even when it is not a perfect line.

In front of the ear, or inside it

There is a real choice here and it is worth asking about. The incision can run just in front of the ear, in the natural crease, or it can be brought inside the small ridge of cartilage at the ear's opening so the line sits within the ear rather than beside it.

The second is more concealed and is usually my preference in women, though it demands care, because a version done without attention to the natural contour can blunt the ridge and produce a subtly artificial looking ear. In men the calculation is different again, since beard hair is being repositioned and an incision placed inside the ear can bring hair bearing skin somewhere it does not belong. The right answer depends on the patient rather than on a fixed rule.

Behind the ear and into the hair

The portion behind the ear is hidden in the crease and then disappears into the hairline. It is the section where any tension in the closure tends to reveal itself, partly because the skin there is thinner and partly because it is the end of the flap. When patients report a widened facelift scar, this is frequently where it is.

The earlobe is the part that gives it away

An earlobe contains no cartilage. It has no internal structure holding its own shape, which means it goes wherever the surrounding skin pulls it.

If a facelift is closed with the skin carrying the tension, the lobe is dragged downward and forward until it appears attached to the cheek rather than hanging free. The result is recognisable to anybody who knows to look, and it is more identifying than any scar. It is also entirely a matter of how the operation was planned and closed rather than how the patient healed, so it is a fair thing to ask about directly and a fair thing to look for in a surgeon's photographs.

A lobe that hangs naturally, with a visible gap between it and the cheek, is one of the better indicators that the deeper layer took the load it was supposed to take.

What the hairline gives away

The other tell is the hair, and it comes in two forms.

The sideburn can be pulled backwards and upwards, leaving a gap of bare skin where hair used to reach, which reads as odd without most observers being able to say why. The temporal hairline can also be lifted, so that the distance between the eyebrow and the hair increases on one side or both.

Both are consequences of how the flap is designed and where the incision is placed relative to hair bearing skin, and both are considerably harder to correct afterwards than a scar is. This is an argument for asking to see a surgeon's results photographed with the hair pulled back, which is the view that would show a problem and the view least often published. Our guide on how to choose a plastic surgeon goes into what else those photographs should show.

Tension is settled beneath the skin

Everything above comes back to one thing, which is which layer of tissue is holding the lift.

Underneath the skin lies a fibrous layer that carries the muscles of expression. When that layer is released and repositioned, it can carry the weight of the lift, and the skin above it is then simply redraped and closed without being stretched. When the deeper layer is left largely alone and the skin is pulled tight instead, the skin is holding a load it is not built to hold, and the consequences are the ones already described: a widening scar behind the ear, a tethered earlobe, a displaced sideburn, and in time a result that relaxes sooner than it should.

This is the practical reason technique matters to a question that sounds cosmetic. Deep plane technique and its relatives exist to move that load off the skin, and the scar you end up with is downstream of that decision. It is also why a comparison between surgeons is rarely a comparison between incisions.

How the scars change over the first year

The trajectory surprises people, so it is worth stating plainly: a fresh scar looks fine, then gets worse, then gets better for a long time.

In the first days the line is usually thin and unremarkable. Somewhere between six weeks and four months it commonly becomes firm, slightly raised and pink or red, because collagen is being produced faster than it is being reorganised. Patients who were not warned about this stage arrive convinced something has failed. It has not.

From there the remodelling runs slowly and quietly, and twelve to eighteen months is the honest window before a scar has settled into its final appearance. Assessing the outcome at three months is assessing a process that is not finished. Hair helps here in a way it does not on the body, since the sections running through the scalp are camouflaged as soon as hair regrows around them. The facelift recovery guide covers the rest of that timeline alongside the swelling and sensation changes that run on a similar clock.

Looking after them while they mature

Two measures are worth the discipline. Silicone, as gel or sheeting, has the most consistent evidence behind any topical scar treatment, started once the incision has fully closed and continued for months rather than weeks. Sun protection matters at least as much, because an immature scar exposed to ultraviolet light can pigment permanently, and the sections of a facelift scar in front of the ear are not reliably shaded by hair.

Nicotine in any form belongs in the same conversation, since it constricts the blood supply to the flap that has to heal. It is the most damaging thing within a patient's own control and it acts on exactly the tissue with the least margin.

When something can be improved

Scars that heal wider or thicker than intended can often be improved, under two conditions. The first is that the scar has fully matured, which means waiting at least a year and usually longer. The second is that whatever produced the problem has been understood, because a scar revised without addressing the cause tends to reproduce itself. Scar revision covers how scars mature and what revision can realistically correct.

Earlobe position and hairline displacement are different problems with different answers. A tethered lobe is corrected by releasing and reinsetting it, which is a genuine procedure rather than a touch up. Lost sideburn or a raised temporal hairline is sometimes better addressed with hair grafting than with another incision, since adding hair solves what moving skin caused.

What to ask before you book

Ask where the incision will run in front of your ear and whether it will be placed inside the cartilage ridge or in the crease, and ask why that choice suits you specifically. Ask how the lift is supported, and whether the deeper layer or the skin is carrying it. Ask what happens to your sideburn.

Then ask to see healed results at a year, photographed with the hair back and the ear visible. Early photographs flatter every surgeon's work. The twelve month view with the ear exposed is the one that answers the question you are actually asking, and a surgeon who offers it without being pressed has been thinking about your scars as part of the operation rather than as its aftermath.

Consultation

If scarring is the reason you have not moved forward with a facelift, that is a reasonable thing to work through in detail, including exactly where the incisions would sit for your anatomy.

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They follow the border of the ear rather than sitting on the face itself. A facelift incision usually begins in the temple hair or at the front edge of the sideburn, runs down in front of the ear or inside the cartilage ridge at its opening, passes under the earlobe, then turns up behind the ear and finishes in the hair at the back of the scalp. Almost the entire length is either inside hair or tucked against an anatomical border. This is why a well placed facelift scar is difficult to find even at conversational distance, and why the visible signs of surgery are usually not the scar line at all.
Once mature they are usually hard to see without being looked for deliberately, because of where they are placed rather than because facial skin heals unusually well. The parts of a facelift that people actually notice are different: an earlobe pulled downward and tethered to the cheek, a sideburn that has been moved backwards, or a temporal hairline that sits higher than it did. Those are contour and hairline changes rather than scars, they are far more recognisable than a fine line beside the ear, and they are decided during planning rather than during healing.
The interim period is worse than both the beginning and the end. A fresh incision often looks unremarkable, then between roughly six weeks and four months it becomes firmer, raised and pink or red as collagen is laid down faster than it is remodelled. From there it settles slowly over the following year, and twelve to eighteen months is the honest window for a final appearance. Judging the result at three months means judging an unfinished process, which is the single most common reason patients become distressed about a scar that was going to be fine.
It describes an earlobe that has been drawn downward and forward so it appears stretched into the cheek instead of hanging free, and it is one of the clearest signs that a facelift was closed under tension. The earlobe has no cartilage to hold its own shape, so if the skin flap is pulling, the lobe follows the pull. Preventing it is a matter of how the deeper tissue layer carries the load and how the lobe is inset at closure, both of which are surgical decisions rather than healing outcomes. Correcting it later is possible but is a genuine revision procedure.
Yes, though the timing and the reason both matter. A scar should be fully mature first, meaning at least a year and often longer, because scars improve on their own for far longer than most people expect and revising early tends to produce a second scar much like the first. It also matters why the scar behaved as it did. A scar that widened because the closure was under tension will widen again unless the tension is addressed, whereas a scar affected by a healing complication or an unusually reactive response has a better outlook. Hairline and sideburn displacement are different problems and are sometimes better addressed with hair grafting than with a further incision.

Related reading: the facelift recovery guide for the weeks after surgery, deep plane facelift for how the lift is supported, facelift versus mini facelift for whether a shorter operation suits you, scar revision for how scars mature, and how to choose a plastic surgeon.