Where Should Facelift Incisions be Made – The Occipital Incision
If a facelift is not performed correctly, problems such as hairline displacement and a poorly formed scar can occur when incising in the occipital area. Traditionally, the occipital incision has been placed high on the scalp over the mastoid in order to hide the scar. This tends to work well for young patients with a small amount of excessive skin on the neck. This incision allows for entry into the lateral neck (not for the purpose of shifting).
When the patient has excessive skin, a high incision on the scalp can cause hairline displacement and create a noticeable scar. Extra skin can be measured by pulling up the skin and measuring the surplus tissue. If there is less than two centimeters, the incision should be made on the scalp. If there is two centimeters or more of extra skin, the incision should be made on the occipital hairline. In order to hide a scar along the hairline, the lower portion of the incision should be positioned posteriorly on the scalp at the seam of the hair.