Quick summary
How a facelift scar looks at one year depends more on the six months of care after surgery than on the incision itself. The three things that matter most are keeping tension and infection off the wound in the first two weeks, protecting the scar from sun and supporting it with silicone between weeks two and twelve, and recognising a hypertrophic reaction early enough to treat it. Scars take roughly twelve months to fully mature, so judging the result at month two is premature.
This page covers what to do at each stage. For where the incisions are placed and how they normally heal, see the overview of facelift scars.
Week 0 to 2: closing the wound
The only goal in the first two weeks is an uneventful closure. Everything else comes later.
Sutures and staples. Facial sutures in front of the ear typically come out around day 5 to 7; staples or sutures in the hairline and behind the ear often stay until day 10 to 14 because those areas are under more tension. Do not remove anything yourself, even if a suture appears loose.
Cleaning. Most surgeons allow gentle cleansing of the incision line from day 2 or 3 with saline or diluted antiseptic, followed by a thin layer of the ointment they prescribed. Keep the line moist, not wet, and do not pick at crusts — they come away on their own as the wound epithelialises.
Hair washing. A first gentle wash is usually permitted between day 3 and day 7, with lukewarm water and no rubbing over the incision. Ask for a specific day rather than assuming.
Tension. Incisions that are pulled heal wider. For the first two weeks avoid wide yawning, laughing hard, turning the head sharply, sleeping on the side, and anything that stretches the skin in front of or behind the ear. Keep the head elevated when sleeping.
Smoking. Nicotine narrows the small vessels that supply the lifted skin flap. In the first two weeks this is the single largest controllable risk for skin loss along the incision, which leaves a scar that no later treatment fully corrects. This includes vaping and nicotine patches.
Week 2 to month 3: the remodelling window
Once the wound has closed, the scar enters a phase where collagen is being laid down and reorganised. This is the window where external care has the most effect.
Silicone. Silicone gel or sheets are the one topical intervention with reasonable evidence behind it for reducing scar thickness and redness. Start once the incision is fully closed (usually week 2 to 3), apply or wear for 12 or more hours a day, and continue for at least two to three months. Gel is easier to use around the ear and hairline; sheets work better on the flatter skin behind the ear.
Sun. Pigmentation in a scar is largely decided in this window. A fresh scar exposed to UV can darken permanently. Use a broad-spectrum sunscreen on any exposed scar daily and wear a hat outdoors for the first three months at minimum.
Massage. Gentle pressure massage along the scar, once the surgeon confirms the wound is stable (typically week 3 to 4), may help soften firm areas. A minute or two, twice a day, with a clean fingertip is enough. Massage should never hurt.
Hair dye and chemical treatments. Dye, bleach, perms and straightening treatments should wait until the incisions are fully healed and the surgeon clears it — commonly four to six weeks. Chemicals on an immature scar can cause irritation and pigment changes.
Using hair to hide the scar is fine, but do not pull hair tightly over the incision with clips or bands in this phase; that is tension.
Month 3 to 12: maturation and early intervention
A normally maturing scar goes from pink or red to pale over this period and flattens. Some itching is normal. What is not normal is a scar that becomes raised, firm, increasingly itchy, or stays deeply red past month three to four. Those are early signs of a hypertrophic scar, and they respond best when treated early.
Options a surgeon may consider for a scar that is thickening include corticosteroid injection into the scar, pulsed-dye laser for persistent redness, and fractional laser for texture. Which is appropriate depends on the scar, the skin type and the timing, so this is a decision for the operating surgeon or a dermatologist — not something to self-treat.
Do not judge the final result before month 12. Scars that look prominent at month four are often unremarkable at month twelve.
Risk factors you can check before surgery
Some people scar more than others, and most of the reasons can be identified beforehand.
- Personal or family history of keloids — the most important factor. Mention it even if the keloid was from an ear piercing.
- Darker skin types (Fitzpatrick IV to VI) — higher rates of both hypertrophic scarring and pigment change.
- Diabetes, long-term steroid use, poor nutrition — slower wound healing.
- Smoking — see above.
- How your previous scars healed — show the surgeon any existing surgical or injury scars. They are the best predictor of how you will heal this time.
If several of these apply, ask the surgeon how they adjust incision placement and closure technique, and whether they plan to start silicone or other measures earlier than usual. A surgeon who has a ready answer has thought about it before.
Comparison: scar profile by technique
The scar you end up caring for depends on which procedure was done.
| Technique | Incision length | Behind the ear | Hairline incision | Where scars are most visible |
|---|---|---|---|---|
| Mini facelift | Short, in front of ear | Usually none or minimal | None | Front of ear only |
| SMAS facelift | Full, around ear | Yes, into scalp | Sometimes (temple) | Behind ear, hairline |
| Deep plane facelift | Full, around ear | Yes, into scalp | Sometimes (temple) | Behind ear, hairline |
| Thread lift | Needle entry points only | No | No | Small marks at temple, fade in weeks |
Longer incisions are not worse scars; they are more scar to look after, and the behind-the-ear portion is where tension and healing problems most often show up.
If you are traveling for surgery
Most of the care in this guide happens after patients have flown home. Before leaving Korea, get written instructions covering suture removal dates, when to start silicone, when hair dye is allowed, and what a problem scar looks like. Ask how the clinic wants to receive photos for remote follow-up, and confirm a local contact in case a scar needs in-person treatment at month three or four. See how to choose a facelift clinic in Seoul for the follow-up questions worth asking before booking.