Male Facelift Surgery: What Happens to the Scar if You Don’t Have Hair?

Hello. I’m Park Hyung-seok, Chief Director of Nuneopho Plastic Surgery.

Recently, more male patients have been visiting the clinic. But even among the many male facelift cases I have seen as a plastic surgeon, there is one moment when I become especially tense: when I meet a bald patient with no hair.

In a typical facelift, hair or sideburns are used like a curtain to cleverly hide the surgical scar.

But what if there is no hair to cover it? The scar around the ear has no choice but to be fully exposed to the world.

Today, based on the real case of a 70-year-old hairless male patient who underwent surgery at Nuneopho Plastic Surgery,

I’d like to explain the three key secrets to perfectly controlling facelift scars even without hair.

The most difficult facelift surgery: surgery for a bald patient

1. Because of scar concerns, asking for a "short incision"? ➡️ That is the worst choice.

Many people, afraid of facelift scars, ask, "Please make the incision as short as possible." This is especially true for those with little hair.

But the reality of surgery is different. If the incision is too short, the excess skin left after lifting sagging skin has nowhere to go and bunches up behind the ear in a wrinkled mass. This is called a "skin roll" phenomenon. People with abundant hair can simply cover it with hair, but for bald patients, the wrinkled skin contours behind the ear are exposed plainly, causing enormous stress.

A case of skin bunching behind the ear due to a short-scar mini facelift (source: textbook)

⚠️ Don’t be fooled by "ponytail lifts" or "vertical mini lifts."

Recently, ponytail lifts and mini lifts that pull the skin upward vertically have become popular. You may be tempted by marketing that says the scars are small, but these surgeries are based on the premise that the scar will be hidden in the hair on the crown or in the sideburns.

If someone with severe hair loss or no hair at all undergoes this kind of vertical lift, what happens? A terrible scar is left right on the bare skin above the ear. You should absolutely avoid surgery that ignores the anatomical characteristics of patients without hair.

Nuneopho Plastic Surgery bald facelift: postauricular scar closed without skin bunching

In Dr. Botti’s paper arguing for a short incision in bald patients, the incision behind the ear was not extended further.

Dr. Botti’s paper

And he has stated that he himself underwent a facelift using the method he taught.

Dr. Botti visiting Korea in 2026

Although the intention was good—to hide the scar—the wrinkled scar behind the ear can be observed.

In fact, unlike what was described in the paper, plastic surgery textbooks state that incision design in bald patients should be done in the same way as in patients with hair.

Incision in a bald patient introduced in Nelligan - by Dr. Marten

2. Did you say beard hair grows behind the ear after surgery? (The solution to hair shift)

When consulting for a male facelift, there is one "opportunity cost" I always explain in advance. Because the skin is pulled toward the ear and sutured, the beard hair follicles from the cheeks or jawline also naturally move backward. If you’re not careful, beard hair can end up growing from the skin behind the earlobe.

This "hair shift" phenomenon is unavoidable, but at Nuneopho Plastic Surgery we address it cleanly with two solutions.

1. Follicle destruction during surgery (Bovie ablation): When the skin is lifted during surgery, the roots of densely packed beard follicles become visible on the inside. Before suturing, these follicles are carefully destroyed with a medical cautery device.

2. Laser hair removal after surgery: Cauterization alone during surgery cannot remove hair 100%. Therefore, after the wound has fully healed and the patient has recovered, any remaining hair growing in an abnormal location is permanently and neatly finished off at the hospital with a hair removal laser.

3. The real secret to hiding scars without hair: "tension-free closure"

So, how did the facelift scar of our 70s patient, who underwent surgery without hair, disappear so seamlessly? The answer is "tension-free skin closure."

A lift is not a surgery that forcibly pulls the outer skin and stitches it shut. The real key is firmly lifting and fixing the SMAS layer, which lies deep beneath the skin. When the lifting force is fully borne by the SMAS layer, the outer skin only needs to be gently draped over the newly repositioned facial structure.

Because there is no tension pulling the skin tightly from both sides when it is sutured, the scar does not spread apart or widen and remains only as a very fine line. Over time, it fades to the point where it is hard to find with the naked eye.

Before-and-after photos of tension-free scar closure at Nuneopho Plastic Surgery

A facelift result at Nuneopho Plastic Surgery with almost invisible scarring because it was closed without tension

💡 Male facelift surgery is complete only when the details of aging are addressed.

Successful surgery does not end with simply smoothing wrinkles. In men, as they age, the earlobes become long, thin, and droopy (so-called "grandpa earlobes"). During a facelift, if those sagging earlobes are corrected to look fuller and shorter, like in younger years, the surprisingly youthful effect that was hidden becomes visible.

Appearance 12 days after a facelift performed on a bald patient

Brow lift and lower eyelid surgery were also performed together

The earlobe correction result

In addition, for this 70s patient with severe eyelid drooping, rather than simply recommending upper eyelid surgery, we also performed a brow lift that can improve sagging while keeping the expression soft, addressing the aging around the eyes completely.

Are you hesitating to undergo facelift surgery because you have no hair? A male facelift without hair requires highly customized planning that allows no margin of error, down to the trajectory of the scar, the movement of beard hair, and the thickness of the skin.

For more difficult cases, please seek a specialist with a deep understanding of anatomy and a commitment to performing the procedure according to standard surgical principles.