Facelift incisions run around the ear and into the hair. Where the surgeon places them decides whether your sideburn survives and how the hairline looks tied up.
A facelift scar starts inside or just in front of the ear, curves under the lobe, climbs behind the ear and then turns into the hair at the back. The visible portion is the part in front of the ear, and in most patients it hides in the natural crease or just inside the cartilage rim. Behind the ear the scar is wider, because that is where the tension is placed deliberately, keeping the front line relaxed and thin.
The commonest giveaway of a facelift is not a scar at all — it is a sideburn that has been pulled upward and backward until it sits above the ear canal. It happens when the incision is taken straight into the temporal hair and the flap is then lifted vertically. We keep the sideburn by carrying the incision along the hairline rather than through it, accepting a fine visible line at the border in exchange for hair that stays where it belongs.
A band of thinning can appear along the incision in the first months, usually from the shock of surgery rather than permanent follicle loss, and most of it grows back by month six. Permanent loss is more likely where closure was tight or cautery was used close to the follicles. If a gap remains after a year, follicular unit grafting into the scar is straightforward and reliable, and we would rather plan that openly than pretend it never happens.
Scars are pink and firm at six weeks, and that is when patients worry most. Silicone gel twice daily from week three, strict sun protection for twelve months, and no smoking are the three measures with real evidence behind them. Hair can usually be washed at day three and coloured at six weeks. By a year the front line is generally invisible under normal light, and a short haircut is realistic again well before that.
Most patients can, provided the sideburn and the temporal hairline were preserved. Tell the surgeon before surgery if you always wear a ponytail, because it changes where the incision is planned.
In front of the ear it usually becomes a fine line most people never notice, but no scar disappears entirely. Behind the ear it is wider and hidden by its position rather than by its quality.