Figure 11.

(A) Incision diagram for primary total composite flap facelift demonstrated on a 57-year-old woman. The incision begins in the temporal hair and angles posteriorly just above the helical root. It then curves downward and makes a sharp posterior angle just above the tragus, then continues just behind the crest of the tragus, turning acutely supero-anterior at the base of the tragus and then following the contour of the intertragal incisure to the upper ear lobe, with a notch just superior to the lobe and then around it. (The postauricular incision runs up the postauricular sulcus and just within the posterior hairline, acutely beveled so that hair grows through the hairless edge of the flap as it heals.) (B) Preauricular incision design for secondary total composite facelift demonstrated on a 60-year-old woman. To avoid raising the sideburn, the incision begins behind the anterior 1/3 of the sideburn with w-plasties which course under the sideburn as depicted. The remainder of the incision is the same as in Figure 11A.