Most patients find the scars acceptable at three to six months and well concealed by twelve months. Individual healing varies with skin type, age, smoking status, and aftercare, and it cannot be predicted with certainty before surgery. What can be planned is the incision pattern, and much of the aftercare that influences the final result sits within the patient’s control.
This guide covers where deep plane facelift incisions are placed, how the scars change through each phase of healing, which factors move the final result, and which scar-management measures have consistent evidence behind them. It also lists the warning signs that should be reported between scheduled follow-ups, and the questions worth raising at a consultation.
How the Deep Plane Technique Affects Scarring
A deep plane facelift releases the retaining ligaments of the face and repositions the SMAS and the deeper tissue as one unit, rather than tightening skin over the deeper layers and relying on that pull to hold the lift. The skin is then redraped over the repositioned tissue without being stretched to carry the load.
Lower tension across the closure is the main reason deep plane scars tend to settle differently from scars under skin-pulling techniques. Tension is the dominant mechanical driver of scar widening, so a closure that is not under stretch generally has a better chance of staying fine and flat. This does not remove scarring: incisions are still required, and placement, closure technique, and the patient’s own healing response still shape the final appearance.
Where the Incisions Sit
Deep plane facelift incisions follow a pattern planned around each patient’s anatomy, hairline, and the extent of the lift, in particular whether the lift extends to the neck. The standard pattern has three connected parts, with an optional fourth under the chin when neck work is combined.
Around the Ear (Preauricular Area)
The preauricular incision runs in front of the ear, following the contour where the cheek meets the ear. It is often placed along the inner edge of the ear’s root so the line falls into the natural crease. Once healed, this portion sits within the shadow of the ear and shows only on close inspection, and it is the one part of the pattern that hair cannot cover.
Behind the Ear (Postauricular Area)
The incision typically continues behind the ear in the crease where the ear attaches to the head, then turns along or into the hairline behind it. This portion carries much of the neck lift. It is concealed by the ear itself and by hair, and it stays out of view even with the hair worn back.
Hairline and Temple Region
A short extension into the temporal hairline or along the sideburn lifts the upper cheek and midface. Placing this part of the incision with care avoids pulling the hairline upward or distorting the sideburn, which keeps the natural frame of the face intact. The exact path depends on hair pattern and the degree of lift required.
When submental work such as neck liposuction or platysmaplasty is combined, a small separate incision is made under the chin. It is not part of every deep plane facelift, and it heals as a short line that sits in the shadow under the jaw.
How Deep Plane Facelift Scars Heal Over Time
Scar maturation is a staged process that runs for up to a year after surgery. The table below sets out the typical stages, and the phases that follow describe them in more detail.
| Stage | Typical timeframe | What is happening |
|---|---|---|
| First week | Days 1–7 | Incisions closed, sutures or staples in place; swelling and bruising dominate the appearance. |
| Suture removal | Days 5–10 | Most surface sutures are removed; the incision is still pink and firm. |
| Early maturation | Weeks 2–6 | Incision lines begin to flatten and shift from red toward pink; still visible on close inspection. |
| Active remodelling | Months 2–6 | Collagen reorganises; the scar softens and lightens steadily. |
| Mature scar | 6–12 months | Final colour and texture are approached; in most patients the scar is a fine line. |
These are typical ranges, not guarantees. Healing moves with skin type, age, smoking status, and aftercare, so an individual scar may run ahead of or behind this schedule.
Early Healing Phase (First 2–3 Weeks)
In the first two to three weeks the scars are pink and may be slightly raised, and swelling and tightness are normal while the tissues settle. For many patients this is when the scars look their most obvious. That is an expected stage of healing rather than a sign of a poor outcome, and it settles as remodelling begins.
Remodeling Phase (1–3 Months)
Through the first three months the incision lines flatten and fade from red toward pink as collagen reorganises, and most patients notice steady improvement in texture and visibility. Activity restrictions are relaxed progressively over this window, and the week-by-week deep plane facelift recovery guide covers the milestones in detail.
Maturation Phase (3–12 Months)
From three months onward the scars continue to soften and lighten, gradually blending into the surrounding skin or hairline. By twelve months the scar is considered mature, and in most patients it is a fine, minimally detectable line. The final judgement on scar quality is generally reserved until this point, because remodelling is still active before it.
What Affects Scar Quality
Even with a well-planned incision and a low-tension closure, several factors influence how the final scar looks. Some sit with the surgery itself, and several sit with the patient.
Closure tension. Tension across the incision is the dominant factor in scar widening. Deep plane techniques reduce it by carrying the lift in the deeper tissue rather than relying on skin pull.
Skin type and pigmentation. Darker skin types (Fitzpatrick IV–VI) carry a higher risk of hypertrophic scarring and post-inflammatory hyperpigmentation. This should be discussed at consultation, because it changes both the risk profile and the aftercare plan.
Smoking. Nicotine impairs wound healing by reducing blood supply to the skin edges, and it raises the risk of poor healing and visibly worse scarring. Stopping around surgery is one of the few measures with a direct, well-documented effect on the outcome.
Sun exposure. Ultraviolet light on a healing incision can cause pigmentation that persists long after the wound has closed. Sun protection over the incisions in the first year is not optional.
Aftercare compliance. Silicone sheeting or gel, taping, and massage protocols have evidence behind them for hypertrophic and widened scars. They only work if they are used as directed, for as long as directed.
Surgical technique. Precise placement in natural creases, a layered closure that takes tension off the skin edge, and care to avoid distorting the hairline all influence the final result.
How to Minimise Scars: What Actually Works
Scar management works in stages, and the measures that matter are unglamorous: preparation before surgery, disciplined wound care in the first weeks, and consistent protection for the first year.
Before surgery. Stop smoking at least four weeks before the operation and stay off nicotine through the early healing period. Raise any personal or family history of keloid or hypertrophic scarring at consultation.
The first weeks. Follow wound-care instructions exactly. Keep the incisions clean and dry as directed, and do not remove crusts or pick at the lines.
Weeks to months. Silicone-based therapy, as sheets or gel, is the most consistently supported non-invasive measure for improving scar quality, with the effect documented across systematic reviews of hypertrophic and widened scars.
Once approved by your surgeon, silicone-based gels or sheets may help improve scar texture and softness.
Through the first year. Keep strict sun protection over the incisions: SPF 50+ reapplied as directed, a hat, and physical shade. Avoid tanning, avoid retinoids on the healing incision, and do not apply non-prescribed topicals until the wound is fully closed.
Massage. Once the wound has fully closed and the surgical team confirms it, gentle scar massage as directed may help soften the tissue.
Common Mistakes and Misconceptions
A few recurring beliefs about facelift scarring deserve correction before they shape expectations.
- “The scars will be invisible within weeks.” Not for most patients. Visible maturation takes months, and the final appearance is judged at twelve months.
- “The deep plane technique means no scars.” Incisions are still required. The technique changes how tension is distributed, not the need for surgical access.
- “Sun protection stops once the wound is closed.” UV exposure on a maturing scar can darken it for up to a year after surgery.
- “Silicone sheeting is a gimmick.” It is the most consistently supported over-the-counter intervention for scar quality.
- “A good surgeon guarantees a good scar.” Technique matters enormously, but skin type, smoking, and aftercare carry significant weight in the outcome.
- “Hair will grow back and hide the scar immediately.” Hair cover over healing incisions varies, and the scar remains visible until it matures even in patients with dense hair.
Risks and Complications Specific to Scarring
Most deep plane facelift scars heal without incident, but the following scar-related complications are recognised and worth knowing about before surgery.
Hypertrophic scarring. A raised, firm scar confined to the incision line. It is more common with higher-tension closures and in certain skin types, and it often improves with treatment over time.
Keloid scarring. Scar tissue that extends beyond the original incision. The risk is partly genetic and higher in darker skin types. A personal or family history should be disclosed at consultation.
Hyperpigmentation. Darkening of the incision line, most often linked to sun exposure during healing.
Hypopigmentation. Lightening of the scar, occasionally seen in mature scars and usually permanent.
Widening. Most often related to tension across the closure, healing problems, or early mechanical stress on the incision.
Alopecia along the incision. Hair follicles along the temporal or postauricular incision can be damaged, causing hair loss that is usually temporary but occasionally permanent.
Revision surgery. Considered for scars that remain conspicuous at twelve months. It is not undertaken earlier, because remodelling is still improving the scar before that point.
When to Seek Help
Contact the surgical team without waiting for the next scheduled follow-up if any of the following appear: increasing redness, swelling, pain, or discharge after the first week, which can indicate infection; a scar that is rising, thickening, or extending beyond the incision line; or any sudden change in colour or breakdown of the wound. Early reporting changes outcomes.
What to Discuss at Consultation
A consultation is the right place to put your own risk profile on the table. Worth raising:
- Your skin type and any personal or family history of abnormal scarring.
- Whether you smoke, and your capacity to stop around the surgery.
- The incision pattern planned for your specific anatomy and hairline.
- How the incision will be closed, including suture choice, glue, or tape.
- The aftercare you are expected to follow, and for how long.
- What the surgeon considers an acceptable scar at twelve months, and what would prompt a revision.
Frequently Asked Questions
Are deep plane facelift scars visible?
Deep plane facelift incisions sit in front of and behind the ear, with extensions into the hairline, and are placed to be concealed by natural contours and hair. Most patients find them well concealed once mature, but well concealed is not the same as invisible, and how an individual heals varies.
How long before deep plane facelift scars fade?
Most of the visible fading happens between three and six months, and the final appearance is generally judged at twelve months. Scars often look their most obvious in the first six weeks, which is a normal stage of healing rather than a sign of a poor outcome.
Can I do anything to make the scars less noticeable?
The measures with the most consistent support are stopping smoking around the time of surgery, strict sun protection for the first year, and silicone-based scar therapy once the wound has closed. Following the aftercare instructions closely also carries real weight in the final result.
Will the scars be hidden by my hair?
Partly. The portions behind the ear and at the temple usually sit within or behind the hairline, but the portion in front of the ear is not covered by hair. Hair also thins with age, so the incision pattern is planned with your long-term hair pattern in mind.
What if my scar heals badly?
Many scars that look concerning early on improve considerably with time. Revision is considered for scars that remain conspicuous at twelve months, once remodelling has finished. A personal or family history of keloid scarring should be raised at consultation, because it changes the risk assessment.
Enquire or Contact Dr Deon
Scarring is one of the most common concerns patients raise at a deep plane facelift consultation. At DW Skin & Body in Fourways, the incision pattern is planned around your anatomy, hairline, and skin type, and aftercare is discussed in detail before surgery so you know what is expected of you and what to expect from the scar. The practice is HPCSA-registered and led by an APRASSA-affiliated specialist surgeon with a KOL role for Galderma South Africa. To discuss a deep plane facelift, call 011 875 1694 or visit Suite B22, Life Fourways Hospital, Corner Cedar Road and Cedar Avenue West, Fourways.
Also Read:
- DEEP PLANE FACELIFT
- Deep Plane Facelift Recovery | Week-by-Week Guide & Healing Tips
- Deep Plane Facelift Incisions | Where They Are Made & Why
This article is general information about scarring after a deep plane facelift and is not medical advice for any individual. Healing, scar quality, and candidacy for revision vary from person to person and can only be assessed in person by a HPCSA-registered practitioner with access to your history and examination. If you are considering this procedure, book a consultation to discuss your own circumstances.
