TMJ Replacement Scar Care: Healing and What to Expect
Edited by Merve Aydin, Health Content Editor · About 6 min read · General information, not medical advice
Quick answer
A TMJ replacement scar usually follows a curved incision just in front of the ear, sometimes extending into the hairline or the ear canal. AAOMS describes total joint replacement as surgery for end-stage joint disease, and the incision is planned to hide in natural creases. Most scars fade over six to twelve months. The priorities are a clean, undisturbed wound early, sun protection for the first year, and prompt review of spreading redness, drainage, or fever.
Where the TMJ replacement scar sits
Surgeons use a few standard approaches. The most common is a preauricular incision that runs down the front of the ear and curves behind the earlobe, similar to a face-lift incision. Some use an endaural approach that hides the cut partly inside the ear canal. A longer approach may extend into the temple hairline for wider access.
That anatomy explains the scar you see: a thin line in front of the ear, often with a slight curve, and sometimes a small extension into the sideburn. Hair usually grows back around it, and glasses or earrings can cover part of it.
AAOMS notes that joint replacement is reserved for severe disease, and the surgical plan includes both the joint and the incision design. If you have not yet had surgery, ask the surgeon where the incision will sit and how it will be closed.
The first two weeks
The wound is the priority. Follow the surgeon's instructions exactly, because they override general advice.
- Keep it dry for the period the surgeon specifies. Sponge baths are usually allowed; direct shower spray may not be.
- Do not apply creams, oils, or makeup until the wound is closed and cleared.
- Sleep with the head raised for the first few nights to limit swelling.
- Use cold packs as directed for the first 48 hours, with a barrier between the pack and skin.
- Avoid stretching the incision. Do not open the mouth wide or pull the skin to look at the scar.
- Take prescribed antibiotics if given, and finish the course.
Some swelling, tightness, and a numb patch in front of the ear are common. Numbness usually improves but can take months, because small sensory nerves are cut during the approach.
Scar care once the wound is closed
When the surgeon confirms the wound is healed, scar care can begin.
Massage. Use clean fingers and light pressure, moving the skin in small circles for a few minutes, once or twice a day. The aim is to keep the tissue mobile, not to break it down. Stop if it becomes painful or red.
Silicone. Silicone gel or sheets are the most studied over-the-counter scar treatment. They help flatten and soften raised scars in some people. Use them on healed skin only, and follow the product directions.
Sun protection. New scar tissue pigments easily. Cover the area with a hat or sunscreen for at least the first year, and longer if it is exposed.
Moisturizer. A plain, fragrance-free moisturizer reduces dryness and itching. Avoid vitamin E oil, which is a common cause of contact dermatitis and has not been shown to improve scars.
Patience. A scar that is red and firm at six weeks is normal. It often softens and fades over six to twelve months.
What scars do over time
| Stage | What you may see | What helps |
|---|---|---|
| 0 to 2 weeks | Fresh incision, swelling, bruising | Keep clean and dry, follow instructions |
| 2 to 6 weeks | Red or pink line, firmness, itching | Silicone, moisturizer, gentle massage after clearance |
| 6 weeks to 6 months | Thickening, color change, tightness | Consistent scar care, sun protection |
| 6 to 12 months | Softening and fading | Time, sunscreen, review if raised |
Some scars become hypertrophic: raised, firm, and sometimes itchy, but confined to the original wound. Keloids extend beyond the wound and are more common in people with darker skin. Both can be treated with silicone, steroid injections, or other methods, but they are easier to manage when seen early.
When to call the surgeon
Contact the surgical team for:
- Spreading redness, warmth, or swelling
- Pus, cloudy drainage, or a bad smell
- Fever
- A wound that opens or drains
- Severe pain that increases instead of settling
- Numbness that spreads or weakness in the face
- A scar that becomes painful, very raised, or restricts opening
These signs can indicate infection, a suture problem, or a nerve issue. Do not wait for a routine follow-up if they appear.
Where scar care fits in recovery
Scar care is one part of recovery. Jaw movement, diet progression, and pain control follow their own timelines. Read TMJ surgery recovery for the wider plan and TMJ surgery scar for scars from other jaw procedures.
If you are considering joint replacement, ask the surgeon about the incision, expected scar, and revision plan. AAOMS guidance treats replacement as a major operation for severe joint disease, not a first-line treatment. For a clinical opinion, browse TMJ doctors near you or the clinics directory.
Frequently Asked Questions
How visible is a TMJ replacement scar?
It sits in front of the ear, often curving behind the earlobe, and fades to a thin line over six to twelve months. Hair, glasses, and earrings can cover part of it.
How long does a TMJ replacement scar take to heal?
The surface closes within one to two weeks, but remodeling continues for six to twelve months. Redness and firmness early on are normal.
Can I use silicone gel on a TMJ scar?
Yes, once the wound is fully closed and the surgeon agrees. Silicone is the most studied over-the-counter option for softening raised scars.
Should I massage my scar?
Gentle massage after clearance can keep the tissue mobile. Avoid deep pressure, especially early, and stop if it becomes painful or red.
Will the scar affect jaw movement?
The scar itself rarely limits opening. Tightness in the surrounding tissue can contribute, which is why gentle movement and physical therapy matter after surgery.
When can I dye my hair or use makeup near the scar?
Ask the surgeon. Hair dye and makeup are usually avoided until the wound is fully closed and any crusting has resolved, often two to four weeks.
References
- American Association of Oral and Maxillofacial Surgeons — AAOMS
- TMJ disorders: diagnosis and treatment — Mayo Clinic — Mayo Clinic
- Scars: diagnosis and treatment — Mayo Clinic — Mayo Clinic
- TMD — National Institute of Dental and Craniofacial Research — NIDCR
- American Academy of Orofacial Pain — AAOP
Medical disclaimer
This page is general education, not medical advice. It does not replace your surgeon's instructions or an examination by a qualified clinician.
Reviewed by the tmjspecialistguide.com editorial team · Last updated 2026-11-07.