In short
- ⚠️ The difference with most clinical weight is haematoma. In a series of 11,300 facelifts, being male was an independent predictor with a relative risk of 3.9: almost four times higher. It is the strongest factor of all those studied.
- The reason is anatomical: facial and neck skin carrying beard follicles has a far richer blood supply, because it has to feed them.
- 🔑 The second difference is the design of the incisions. Two things have to be avoided: moving the sideburn backwards and taking beard-bearing skin behind the ear or into the outline of the ear.
- That is why the incision hidden behind the tragus, which is the usual one in women, is not always the right choice in a man.
- The third is coverage: with a receding hairline or hair loss, there is less hair to hide the temple and nape incisions, and the route is adapted.
- 🔑 And what does NOT change: in 25 years of experience and 1,089 patients, men and women had similar results and similar revision rates.
- Surgery in men is not rare but it is a minority: in that series of 11,300 facelifts, 8.8% of patients were men.
It is the same operation, and there are three things that genuinely change. None of them is the one usually given.
It does not change because men “want something different” or because they age differently: it changes because the skin of a man’s face and neck has a richer blood supply, because there is hair where a woman has none, and because the hair coverage available to hide a scar is often less.
The good news — and it is a figure, not a consolation — is that the result and the revision rate are similar to those in women.
Difference 1: blood supply and haematoma
It is the one to know about before deciding anything.
Haematoma is the most frequent complication of a facelift in any patient. In a prospective cohort of 11,300 facelifts, it appeared in 1.1% of the total — and multivariate analysis identified male sex as an independent predictor, with a relative risk of 3.9.
In another database, with 13,346 patients, male sex again featured among the factors associated with a higher probability of adverse events, along with obesity, current smoking, the length of the operation and combined procedures.
Why. The skin of the face and neck that carries the beard follicle needs far more blood supply than hairless skin. It is a more vascular area, and a more vascular area bleeds more when it is undermined.
What is done about it. None of this makes a facelift in men an inadvisable operation — the absolute rate is still low. What changes is how demanding two specific points become:
- ⚠️ Blood pressure control before, during and above all in the first few hours.
- ⚠️ Reviewing anticoagulants, antiplatelet drugs and supplements, including those not thought of as medication.
And it makes the warning signs of the first twenty-four hours even more relevant: they are on the page about facelift risks.
Difference 2: where the incision can go
This is where surgery in men is designed differently, and it is purely geometric.
In a facelift, skin is redistributed upwards and backwards. In a woman that moves hairless skin. In a man, it moves beard-bearing skin — and you have to decide where it goes.
What has to be avoided:
- Taking beard-bearing skin into the outline of the ear. The retrotragal incision — hidden behind the tragus — is the one that disguises best and is the usual choice in women. In a man it can end up placing skin that grows a beard inside the contour of the ear, with the result of having to shave there. That is why in many cases the route in front of the tragus is preferred, in the natural crease: it shows a little more and it does not move the beard.
- Taking beard-bearing skin behind the ear or into the nape, for the same reason.
- Moving the sideburn backwards. If the temple incision runs inside the hair and is tensioned upwards, the sideburn rises or is lost. It is one of the details that most gives surgery away in a man.
🔑 Practical consequence: in a facelift in men a slightly more visible scar is often accepted in exchange for not moving the beard or the sideburn. It is a deliberate design decision, and it is worth explaining before surgery rather than afterwards.
And that is exactly how we work here: the route does not come from a general rule but from each face — skin type, sex, and above all how far the beard hair reaches. In a man that usually leads to the route in front of the tragus; in someone with little beard growth or with the beard absent from that area, it need not.
The full route of the incisions and what can happen around them is on the page about facelift scars.
Difference 3: how much hair there is to hide it
Two stretches of the incision — the temple and the exit towards the nape — are hidden in the scalp. With a markedly receding hairline, a high hairline or established hair loss, that hiding place is smaller or does not exist.
That means deciding the route according to each person’s hair:
- If there is good hair at the temple, the incision can run inside it.
- If the hairline is receding, running inside the hair means the scar will fall in an area with no coverage, and sometimes it is better to take it in front, at the hairline itself.
And there is a factor for the future worth bearing in mind: male pattern hair loss progresses. An incision well hidden at 50 can be exposed at 60. It is a conversation that makes sense to have beforehand.
⚠️ In addition, the incision crosses scalp and can leave a bald strip along the scar, usually temporary. In an area with low density to begin with, it shows more.
What does not change
This is the part that surprises people and it is worth saying clearly.
A paper covering 25 years and 1,089 patients of facial rejuvenation surgery concludes, among its observations, that men and women had similar results and similar revision rates.
In other words: the surgery is technically more demanding in some respects, the risk of haematoma is higher, the design of the incisions has more constraints — and with all of that, the result and the need to revise it come out similar.
Nor do these change:
- The recovery times. The same: stitches between day 7 and day 10, back to work between two and three weeks, result settled at around six months.
- The indication. What decides which scope applies is still where the laxity is, not sex.
- What a facelift does not do. It does not treat the eyelids, or skin quality, or volume.
Shaving after surgery
A specific, practical question that almost nobody answers.
After a facelift, the mobilised skin is left numb — above all in front of the ear and at the lobe, because of the great auricular nerve — and that sensation takes months to come back fully. Shaving over an area you cannot feel calls for more care than usual for a while.
🔑 Here the interval is this: from the removal of the stitches, at seven days, it is already safe to shave — including over the scarred areas.
It is worth understanding why those two things go together. At seven days the wound is closed and the skin will take the razor; what has not come back yet is sensation. So the care needed over the following weeks is not about the wound: it is about not feeling what you are doing. Go slowly, use the touch of your other hand as a guide, and do not assume you would feel a cut.
⚠️ Before seven days, no. And if at the removal of the stitches some area is not fully closed, your surgeon moves that date.
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Frequently asked questions
Is a facelift riskier in men?
The risk of haematoma is clearly higher: in a series of 11,300 facelifts, male sex was an independent predictor with a relative risk of 3.9. The cause is the richer blood supply of the skin carrying the beard follicle. The absolute complication rate is still low.
Will my beard be moved out of place?
It should not be, and avoiding it is precisely what shapes the design of the incisions. The aim is not to take beard-bearing skin into the outline of the ear or behind it, and not to move the sideburn backwards.
Why would my scar run in front of the ear and not be hidden behind the tragus?
Because the retrotragal incision, which is the one that disguises best, can place skin that grows a beard inside the contour of the ear. In many men the route in front of the tragus is preferred: it shows a little more and it does not move the beard.
My hairline is receding. Will the scar show?
It is one of the factors that shape the route. With little hair at the temple, hiding the incision inside the scalp may not work, and sometimes it is preferable to take it to the hairline. It is also worth bearing in mind that hair loss progresses with the years.
Is the result worse in men?
Not according to the available data. Twenty-five years of experience with 1,089 patients found similar results and revision rates in men and women.
When can I shave again?
From the removal of the stitches, at seven days, and including over the scarred areas. By then the skin will take the razor; what has not come back is sensation, and that takes months. The care needed over the following weeks is about that: shaving over an area you cannot feel means going more slowly than usual.
How many men have this surgery?
They are a minority but not a rarity: in a prospective cohort of 11,300 facelifts, 8.8% of patients were men, a higher proportion than in other cosmetic procedures in the same database.
Sources
- Gupta V, et al. Preoperative Risk Factors and Complication Rates in Facelift: Analysis of 11,300 Patients. Aesthetic Surgery Journal, 2016. PMID 26578747. — Prospective cohort of 11,300 facelifts with 8.8% male patients; haematoma in 1.1% of the total; male sex as an independent predictor of haematoma with a relative risk of 3.9 on multivariate analysis.
- Chopan M, Samant S, Mast BA. Contemporary Analysis of Rhytidectomy Using the Tracking Operations and Outcomes for Plastic Surgeons Database with 13,346 Patients. Plastic and Reconstructive Surgery, 2020. PMID 32459769. — Male sex among the factors associated with a higher probability of adverse events, along with obesity, current smoking, length of the operation, combined procedures, general anaesthesia and an office-based operating theatre.
- Rohrich RJ, Narasimhan K. Long-Term Results in Face Lifting: Observational Results and Evolution of Technique. Plastic and Reconstructive Surgery, 2016. PMID 27348643. — Twenty-five years of experience and 1,089 patients: men and women showed similar results and revision rates.
- Cervicofacial Rhytidectomy. StatPearls, NCBI Bookshelf. NBK564338. — Higher incidence of haematoma in men, attributed to the richer blood supply of facial and neck skin carrying the beard follicle; design and route of the incisions; peri-incisional alopecia among the complications described; involvement of the great auricular nerve as the most frequent sensory change.
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If you are considering a facelift, there are two things worth settling in clinic before anything else: your blood pressure and your medication, because of the risk of haematoma, and where the incision would run in your case, drawn on your own face taking into account your sideburn, your beard and your hair. At the assessment consultation in Valencia both are done.
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Last reviewed: 6 September 2026. This content is for information only and does not replace an individual assessment by a healthcare professional.
