TMJ Surgery Scar: Incisions, Healing, and Scar Care
Edited by Merve Aydin, Health Content Editor · About 6 min read · General information, not medical advice
Quick answer
A TMJ surgery scar depends on the operation: arthrocentesis leaves only needle punctures, arthroscopy leaves two or three tiny portal marks, and open joint surgery uses an incision in front of the ear, often hidden in a skin crease. AAOMS describes these procedures as different levels of invasiveness, and the scar follows that difference. NIDCR notes that surgery is reserved for selected cases, and AAOP guidance favors conservative care first. Most facial incisions heal well because the face has rich blood supply, but maturation takes six to twelve months.
Where the incisions go
Arthrocentesis uses needles, not a scalpel. You may see small puncture marks where the needles entered, and they usually fade without a visible scar.
Arthroscopy uses two or three portals, each a few millimeters wide, placed around the joint. They are small enough that many people struggle to find them after a year. A single stitch or no stitch may be needed.
Open joint surgery uses a preauricular incision, which runs vertically in front of the ear and is often curved into a natural crease. Surgeons may extend it slightly into the hairline or behind the ear to hide the ends. The length depends on access needed.
Joint replacement typically combines a preauricular approach with a second incision below the jaw angle for the ramus component. That lower incision may be placed in a skin crease or below the jawline.
| Procedure | Incision | Typical scar |
|---|---|---|
| Arthrocentesis | Needle punctures | Usually none visible |
| Arthroscopy | 2 to 3 small portals | Tiny dots, often faint |
| Open disc or joint surgery | Preauricular | Line in front of the ear |
| Joint replacement | Preauricular plus lower incision | Longer, two sites |
How the scar changes over the first year
A fresh scar is raised, pink, and firm. That is normal. Collagen is being laid down and the tissue is contracting. During the first month, it may feel tight, itch, or sting.
By six weeks, the redness usually begins to fade and the surface flattens. By three months, the scar is softer and less noticeable, though it may still be visible in certain light. Maturation continues for up to a year or longer.
Sun exposure is the main avoidable factor that makes a scar darker and more persistent. Facial skin is exposed constantly, so sun protection matters for the first year, not just the first month.
Some people form hypertrophic scars, which stay raised and red within the incision line. Keloids extend beyond the original wound and are more common in darker skin tones. Neither is dangerous, but both change the treatment plan.
Scar care that helps
Keep the incision clean and dry as instructed until it closes. Do not pick at scabs or scrub the area. Once the surgeon confirms it is healed, gentle care begins.
Silicone gel or silicone sheeting has the most consistent evidence among noninvasive scar treatments. It can soften and flatten a scar when used consistently for several weeks. Massage with a fragrance-free moisturizer can help once the tissue is stable.
Sun protection is not optional. Use a broad-spectrum sunscreen on the area and consider a hat or scarf. Avoid harsh products, alcohol-based toners, and exfoliants near the incision.
Do not start scar massage, stretching, or silicone until the surgeon says the wound is closed and stable. Starting early can reopen the incision or introduce infection.
What can be revised later
Most scars improve on their own, so surgeons usually wait six to twelve months before discussing revision. A revision may involve re-excising the scar, smoothing contour irregularities, or injecting a steroid into a raised scar.
Steroid injections can flatten hypertrophic scars. They are usually repeated every few weeks and are not appropriate for every scar type. Keloids may need a combination of approaches and have a higher recurrence rate.
Cosmetic camouflage can help in the meantime. Makeup designed for scars, hairstyle changes, and glasses can reduce visibility. These are reasonable options while waiting for maturation.
When to call the surgeon
Call if the incision spreads, drains pus, becomes hot and swollen, or if you develop a fever. Increasing pain after the first week, a bad smell, or a wound that reopens needs prompt review.
Call if the scar becomes thick, itchy, and painful, or if it starts to extend beyond the original line. Early treatment of a hypertrophic scar or keloid is easier than late treatment.
Call if you cannot close your eye on the operated side, if the face looks asymmetric in a new way, or if you have numbness that is getting worse rather than better. These can reflect nerve involvement and need assessment.
For the procedure context, read TMJ surgery recovery, TMJ arthroscopy scar, and surgery success rates. If surgery is being considered, when is TMJ surgery needed covers the decision.
Frequently Asked Questions
Will TMJ surgery leave a visible scar?
It depends on the procedure. Arthrocentesis leaves no meaningful scar, arthroscopy leaves tiny portal marks, and open surgery leaves a line in front of the ear that often fades into a crease.
How long does a jaw surgery scar take to fade?
Redness and firmness usually settle over three to six months, with full maturation taking up to a year or more. Sun protection and silicone can improve the final appearance.
Can I hide a TMJ scar with hair or makeup?
Often yes. Many preauricular incisions sit in front of the ear and can be covered with hair or scar-safe makeup once healed. Ask the surgeon before applying products.
When can I start scar massage?
After the surgeon confirms the wound is closed and stable, which is often a few weeks. Starting too early can irritate the incision or introduce infection.
Does silicone really help scars?
Silicone gel and sheeting have the most consistent evidence for softening and flattening scars. They work better when used consistently after healing, not on an open wound.
Can a TMJ scar be removed completely?
No scar can be removed completely. Revision can make it less noticeable, and steroid injections can flatten a raised scar, but some mark usually remains.
References
- TMD — National Institute of Dental and Craniofacial Research — NIDCR
- American Academy of Orofacial Pain — AAOP
- American Association of Oral and Maxillofacial Surgeons — AAOMS
- Temporomandibular Disorders — American Dental Association — ADA
- TMJ disorders — Mayo Clinic — Mayo Clinic
Medical disclaimer
This page is for general education and is not medical advice. It does not replace an exam by a surgeon or physician. Seek prompt care for wound drainage, fever, spreading redness, or a scar that becomes painful and raised.
Reviewed by the tmjspecialistguide.com editorial team · Last updated 2026-11-07.