Since one of the most obvious signs of surgery is the formation of scars, it is important to thoroughly evaluate each patient to determine the exact placement and length of incisions.
During facelift surgery, an incision is generally made behind the ear, in front of the ear, and along the hairline where it is well hidden. The incision that runs along the hairline near the temples must be carefully incised and sutured or it could shift the location of the sideburns and hair, resulting in an unnatural appearance.
Before making any temporal incisions, it is critical to evaluate the distance of the lateral orbit and the temporal hairline (since this distance expands with age) and to estimate how much skin will be shifted during the procedure (which can simply be done by lifting up the skin). The distance and estimated amount of skin shift will help determine the placement of the incision.
Some surgeons prefer to create an incision further in the temporal scalp help to hide scars instead of along the hairline, but this is likely to cause hair displacement. When the sideburns and hair appear higher than normal, the side of the face appears unnatural and asymmetrical. If there is any concern for shifting the hairline, it is best to place the incision along the hairline to keep the hair at a natural position. If performed correctly, the scar along the hairline should heal very well and blend with the hairline.