Hiding the posterior scar in rhytidectomy: the omega incision

A periauricular pattern of incision is presented for rhytidectomy that resembles an inverted omega. Although the anterior component remains similar to existing recommended patterns, the posterior component allows confinement of the scar to the postauricular sulcus and superior scalp. Although hidden, the scar placement permits full correction of redundant neck skin. The technique entails significant posterior dissection of the scalp, adding operative time and costs, along with increased potential for hematoma and sensory alteration of the scalp. On the other hand, the pattern of scar appears to reduce significantly the incidence of scar hypertrophy, whereas it conceals the scar from view, allowing an unrestricted range of postoperative hair styles.