Scars After a Deep Plane Facelift: What to Expect and How to Minimize Them

Understanding Scar Formation After Deep Plane Facelifts

When you choose a deep plane facelift, you’re investing in one of the most effective facial rejuvenation procedures available. However, like any surgical procedure, scarring is a natural part of the healing process. The good news? With proper technique, strategic incision placement, and diligent post-operative care, facelift scars typically become barely noticeable over time.

A deep plane facelift involves lifting the deeper layers of facial tissue beneath the SMAS (superficial musculoaponeurotic system) to provide longer-lasting, more natural-looking results than traditional facelifts. This technique requires carefully placed incisions, typically hidden along the hairline, temple, and behind the ears—areas designed to conceal scarring as much as possible.

Understanding how scars form and what you can do to minimize their appearance is essential for setting realistic expectations and taking an active role in your recovery.

The Science Behind Scar Formation

Scarring occurs as your body’s natural response to surgical trauma. When your surgeon creates incisions, your body initiates a complex healing process involving three distinct phases. Each phase plays a crucial role in how your final scar will appear.

Why Deep Plane Facelifts May Result in Different Scarring Than Traditional Facelifts

The deep plane technique actually offers several advantages when it comes to scarring. Because the surgeon works deeper in the facial layers, the superficial skin incisions are often smaller and more strategically placed. Another key benefit is reduced tension on the skin closure. One of the most important factors in how a scar ultimately looks is the amount of tension placed on the incision line—greater tension can cause scars to spread and appear more visible over time. In a deep plane facelift, the lifting force is applied to the deeper structural layers rather than the skin itself, which helps minimize tension on the incision during closure. As a result, patients may experience more refined, less noticeable scars compared to traditional SMAS facelifts, which require more extensive skin undermining and can place more stress on the skin surface.

The Three Phases of Scar Maturation

Your facelift scars will evolve significantly over the first 12-18 months following surgery. Understanding these phases helps you know what to expect and when to expect it.

Phase 1: The Inflammatory Phase (Days 1-7)

Immediately after surgery, your body’s inflammatory response kicks in. During this phase:

• Incisions appear red and swollen – This is completely normal and expected
• Bleeding and oozing may occur – Your surgeon will provide specific wound care instructions
• Pain and discomfort are managed with prescribed medications – Follow dosing instructions carefully
• Scars may look worse before they look better – Don’t be alarmed; this is temporary

What You Should Do:

• Keep incisions clean and dry as directed by your surgeon
• Take prescribed antibiotics to prevent infection
• Avoid touching or picking at incision sites
• Sleep with your head elevated to reduce swelling
• Apply ice packs (wrapped in cloth) for 15-20 minutes at a time during the first 48 hours

Phase 2: The Proliferative Phase (Weeks 2-6)

During this phase, your body actively rebuilds tissue and produces collagen to close the wound. Incisions typically appear more prominent during this stage.

• Scars may appear raised, firm, or slightly darker – This is due to increased collagen production
• Redness intensifies before gradually fading – Patience is key during this phase
• Itching and tightness around incisions are common – Resist the urge to scratch
• Swelling gradually decreases – Most patients can return to normal activities by week 3-4

What You Should Do:

• Begin gentle scar care with prescribed topical treatments around week 2-3
• Start using silicone gel sheets or ointments as directed
• Avoid strenuous exercise and heavy lifting
• Protect incisions from sun exposure with SPF 30+ sunscreen
• Continue following post-operative instructions from your surgeon

Phase 3: The Maturation Phase (Weeks 6-18 Months)

This is the longest phase, but also the most rewarding. During maturation, your scars gradually fade, flatten, and blend with surrounding skin.

• Scars gradually flatten and soften – Most noticeable improvement occurs in the first 3-6 months
• Redness fades to pink, then to skin tone – This process can take 12-18 months
• Scars become increasingly inconspicuous – By 12 months, most patients report scars are barely visible
• Final scar appearance stabilizes – Full maturation typically occurs by 18 months

What You Should Do:

• Continue using scar management products (silicone sheets, creams, oils)
• Maintain strict sun protection on healing scars
• Perform gentle massage as directed by your surgeon
• Maintain a healthy diet rich in protein, vitamins, and minerals
• Stay hydrated to support skin healing
• Avoid smoking, which impairs wound healing

Realistic Scar Appearance Timeline: What to Expect at Each Milestone

One of the most important aspects of facelift recovery is understanding realistic expectations. Here’s what you can typically expect:

3 Weeks Post-Op:

• Incisions are closed and mostly healed
• Redness is prominent; scars may appear darker than surrounding skin
• Swelling is significantly reduced
• Most patients can return to work and social activities with makeup

6 Weeks Post-Op:

• Scars begin to fade from red to pink
• Raised appearance starts to flatten
• Incisions are fully healed
• Advanced scar treatments can be considered if needed

3 Months Post-Op:

• Significant fading and flattening has occurred
• Scars blend much better with surrounding skin
• Most patients report scars are barely noticeable
• Continued improvement will occur over the next 9 months

6 Months Post-Op:

• Scars continue to fade and mature
• Color approaches normal skin tone
• Texture becomes smoother and more natural
• Incision lines are typically only visible upon close inspection

12 Months Post-Op:

• Scars are mature and stable
• Most patients report scars are virtually invisible in normal lighting
• Makeup easily conceals any remaining visibility
• Final results are largely achieved

Immediate Post-Operative Scar Care: The First Two Weeks

The first two weeks after surgery are critical for optimal scar formation. Your surgeon’s post-operative instructions are your roadmap to minimizing scarring.

Follow Your Surgeon’s Instructions Precisely

This cannot be overstated. Your surgeon has designed a specific post-operative protocol based on your individual anatomy, skin type, and the specific technique used. Following these instructions exactly—including wound care, activity restrictions, and medication schedules—directly impacts scar formation.

Keep Incisions Clean and Dry

• Gently cleanse incisions with mild soap and water as directed
• Pat dry with a clean, soft cloth
• Avoid submerging incisions in water (baths, pools, hot tubs) until cleared by your surgeon
• Change dressings as instructed
• Watch for signs of infection: increased redness, warmth, pus, or fever

Use Prescribed Topical Treatments

Your surgeon may prescribe or recommend specific topical treatments to support healing and reduce scar formation:

• Antibiotic ointments – Prevent infection during the first 1-2 weeks
• Steroid creams – Reduce inflammation and may help prevent hypertrophic (raised) scars
• Silicone-based products – Begin around week 2-3 to hydrate and flatten developing scars

Manage Pain and Swelling Appropriately

• Take prescribed pain medications as directed
• Use ice packs (wrapped in cloth) for the first 48 hours
• Sleep with your head elevated on 2-3 pillows to reduce swelling
• Avoid NSAIDs (like ibuprofen) unless specifically approved by your surgeon, as they can increase bleeding

Long-Term Scar Management: Weeks 2 Through 18 Months

Once your incisions are fully healed, you can implement comprehensive scar management strategies to optimize your results.

Silicone Gel Sheets and Products

Silicone is one of the most evidence-based treatments for scar management. These products work by:

• Hydrating the scar tissue
• Flattening raised scars
• Reducing redness and discoloration
• Creating an optimal environment for collagen remodeling

How to Use:

• Apply silicone sheets for 12+ hours daily (many patients wear them overnight)
• Use silicone gel or ointment 2-3 times daily
• Continue for at least 3-6 months, ideally through the first year
• Reapply after cleansing and before makeup

Sun Protection: Non-Negotiable

Sun exposure is one of the most damaging factors for healing scars. UV rays can:

• Darken scars, making them more visible
• Slow the fading process
• Increase redness and inflammation
• Compromise collagen remodeling

Sun Protection Protocol:

• Use SPF 30+ broad-spectrum sunscreen on scars daily
• Reapply every 2 hours if outdoors
• Wear a wide-brimmed hat when possible
• Avoid direct sun exposure for at least 6 months
• Consider physical sunscreen (zinc oxide, titanium dioxide) for sensitive healing skin
• Maintain sun protection for the full 12-18 month maturation period

Gentle Massage

Starting around week 3-4 (once incisions are fully healed), gentle massage can help:

• Break down excess collagen
• Improve blood flow to the area
• Flatten raised scars
• Improve scar texture and appearance

Massage Technique:

• Use gentle, circular motions with your fingertips
• Apply light pressure—never aggressive
• Massage for 5-10 minutes, 2-3 times daily
• Use a moisturizer or scar cream to reduce friction
• Avoid massage if scars are still red, raised, or tender

Topical Scar Treatments

Beyond silicone sheets and gels, certain topical options can further support scar maturation. In our practice, we recommend a specialized liquid silicone product called Silagen, which is formulated to hydrate the scar, support collagen remodeling, and help improve overall texture and color as the incision heals. Patients typically apply Silagen consistently over several months to optimize results. Retinol-based creams may also be recommended in select cases to promote gentle skin cell turnover and support long-term scar refinement.

Nutrition and Lifestyle Factors

Your body’s ability to heal optimally depends on proper nutrition and lifestyle choices:

Protein and Amino Acids:

• Collagen is made of amino acids; adequate protein supports scar tissue remodeling
• Aim for 0.8-1.0g protein per pound of body weight daily
• Include sources like chicken, fish, eggs, legumes, and dairy

Vitamins and Minerals:

• Vitamin C – Essential for collagen synthesis; found in citrus, berries, and leafy greens
• Vitamin E – Antioxidant that supports skin healing
• Zinc – Critical for wound healing; found in oysters, beef, and pumpkin seeds
• Iron – Supports oxygen delivery to healing tissues

Hydration:

• Drink at least 8-10 glasses of water daily
• Proper hydration supports skin elasticity and healing
• Avoid excessive alcohol, which dehydrates skin

Sleep:

• Aim for 7-9 hours nightly
• Growth hormone peaks during sleep, supporting tissue repair
• Sleep on your back to avoid pressure on healing scars

Avoid These:

• Smoking – Severely impairs wound healing and increases scar visibility
• Excessive alcohol – Dehydrates skin and impairs healing
• Strenuous exercise – Wait at least 3-4 weeks before resuming normal activity
• Facial expressions that stress incisions – Avoid excessive smiling or frowning for the first 2-3 weeks

Advanced Scar Treatment Options for Persistent Scars

While most facelift scars fade significantly with conservative management, some patients benefit from professional treatments for stubborn or hypertrophic (raised) scars.

Laser Therapy

Laser treatments can effectively reduce scar appearance by:

• Stimulating collagen remodeling
• Reducing redness and discoloration
• Flattening raised scars
• Improving overall skin texture

Common Laser Options:

• Fractional CO2 laser – Effective for raised or textured scars
• Pulsed dye laser (PDL) – Targets redness and vascular components of scars
• Erbium laser – Gentler option for surface-level scar improvements

Timing: Typically performed 6-12 weeks after surgery, once initial healing is complete.

Steroid Injections

For hypertrophic (raised, firm) scars, steroid injections can:

• Flatten raised tissue
• Soften scar firmness
• Reduce redness
• Improve overall appearance

Procedure: Small injections of steroid solution directly into the scar tissue; typically requires 2-4 treatments spaced 4-6 weeks apart.

Microneedling

This minimally invasive treatment creates controlled micro-injuries to stimulate collagen production:

• Flattens raised scars
• Improves scar texture
• Reduces discoloration
• Promotes natural collagen remodeling

Timing: Can be performed 8-12 weeks post-op; multiple sessions (3-6) typically recommended for optimal results.

Combination Approaches

For stubborn scars, combining treatments often yields superior results:

• Laser therapy + steroid injections
• Microneedling + topical treatments
• Laser + silicone products + sun protection

Discuss combination options with your surgeon if conservative management alone isn’t achieving your desired results.

Scar Revision: When Initial Results Need Refinement

In rare cases, if a scar doesn’t mature as expected or becomes problematic, scar revision is an option. This typically involves:

• Refining the incision line with more precise surgical technique
• Repositioning the scar to follow natural skin tension lines
• Using advanced closure techniques to minimize future scarring

Timing: Scar revision is typically performed 12-18 months after the initial procedure, once full maturation has occurred and you can accurately assess the final scar appearance.

Factors That Influence Scar Appearance

Several individual factors affect how your scars will look:

Genetics and Skin Type

• Darker skin tones – May be more prone to hypertrophic or keloid scars; require more aggressive scar management
• Fair skin – Scars may appear more visible initially but typically fade well
• Family history – If family members have prominent scars, you may be predisposed to similar scarring

Age

• Younger patients – Often heal quickly but may have more active collagen production, leading to more prominent scars initially
• Older patients – May have slower healing but often develop less visible scars due to reduced collagen production

Skin Quality and Sun Damage

• Sun-damaged skin – May scar more prominently and heal more slowly
• Healthy, well-maintained skin – Typically produces better scar outcomes

Smoking Status

• Smokers – Experience significantly delayed healing and more visible scarring
• Non-smokers – Achieve optimal healing and scar maturation

Adherence to Post-Operative Instructions

• Strict adherence – Results in optimal scar outcomes
• Poor compliance – Can lead to complications and more visible scarring

Choosing the Right Surgeon: The Foundation for Minimal Scarring

Perhaps the most important factor in minimizing facelift scars is selecting a highly skilled, experienced surgeon. The surgeon’s technique directly impacts scar formation.

What to Look For:

Experience with Deep Plane Technique:

• Ask how many deep plane facelifts your surgeon performs annually
• Inquire about their specific approach to incision placement and closure
• Request before-and-after photos specifically showing scar outcomes

Meticulous Surgical Technique:

• Precise incision placement along natural skin tension lines
• Careful tissue handling to minimize trauma
• Advanced closure techniques that reduce tension on incisions
• Attention to detail in every layer of closure

Comprehensive Post-Operative Care:

• Detailed post-operative instructions
• Regular follow-up appointments to monitor healing
• Willingness to address concerns and adjust care as needed
• Access to advanced scar treatments if needed

Patient Reviews and Testimonials:

• Read reviews specifically mentioning scar outcomes
• Ask to speak with previous patients about their scar experience
• Review before-and-after galleries with focus on scar visibility

Frequently Asked Questions About Facelift Scars

Will my facelift scars be visible?

Initially, yes—scars appear red and raised for the first few weeks. However, with proper care and time, most facelift scars become barely noticeable within 3-6 months and virtually invisible by 12 months. Incision placement behind the hairline and ears helps conceal scarring.

How long does it take for facelift scars to fade?

Scars evolve over 12-18 months. Most significant fading occurs in the first 3-6 months, with continued improvement through month 18. Full maturation typically occurs by 12-18 months post-op.

Can I do anything to prevent facelift scars?

You cannot prevent scars entirely, but you can minimize their appearance through proper post-operative care, sun protection, scar management products, and healthy lifestyle choices. Surgeon selection is also critical.

What if my scars don’t fade well?

If scars remain prominent after 12 months, advanced treatments like laser therapy, steroid injections, or microneedling can help. Scar revision is also an option in rare cases.

When can I use makeup to cover scars?

Most patients can use makeup around week 2-3, once incisions are fully closed. Use gentle application and ensure makeup is removed carefully to avoid irritating healing scars.

Is there a specific scar cream I should use?

Your surgeon will recommend specific products based on your individual needs. Silicone-based products are evidence-based and widely recommended. Avoid products with unproven ingredients.

Can I exercise while scars are healing?

Avoid strenuous exercise for at least 3-4 weeks post-op. Increased blood pressure and sweating can compromise healing. Resume gradually as cleared by your surgeon.

Will sun exposure affect my scars?

Yes—UV exposure can darken scars and slow fading. Use SPF 30+ sunscreen and avoid direct sun for at least 6 months. Sun protection should continue through the full 12-18 month maturation period.

Conclusion: Your Scars Are Part of Your Transformation

Facelift scars are a temporary part of your journey to a more youthful, refreshed appearance. While they may seem prominent in the immediate post-operative period, they represent your body’s remarkable ability to heal and rejuvenate itself.

By understanding the scar maturation process, following your surgeon’s post-operative instructions meticulously, and implementing comprehensive scar management strategies, you can optimize your results and achieve the beautiful, natural-looking outcome you deserve.

Remember: the investment you make in proper scar care during the first 12-18 months directly impacts your long-term satisfaction with your facelift results. Your scars will fade, and your refreshed appearance will shine through.

If you have concerns about your scars during recovery, don’t hesitate to contact our office. We’re here to support you every step of the way.