Swelling 14 Days After Lower Face Lift - Should I Be Concerned?

14 days after lower face lift the left side of my face remains swollen. On waking from the anaesthetic I had difficultly closing my left eye which still causes me problems. I have no conrol to the left side of my nose or left side of upper lip.As I talk my mouth becomes very twisted. I have severe bilateral muscle pain when talking or eating. My PS prescribed prednisolne 2.5mg twice daily and valium 2.5mg three times daily. Is this unusual and should I be concerned as my plastic surgeon is not.

Doctor Answers (8)

Swelling after facelift

+1

I would be concerned. Sounds like a motor nerve injury. May improve with time and steroids but may not.


Miami Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Face lift swelling 14 days later and trouble moving face on left side

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This is not uncommon after 14 days. At this point you likely have around 20-40%% of your healing. We usually tell people that they will have 60% of their healing / recovery complete by 6 weeks, 80-90% by 6 months. 100% can take as long as 2 years. This is based on wound healing studies and tensile breaking strength of a heal wound.  You have a while to go for complete healing. The left side and the trouble with moving your face here could be some stimulation of your facial nerve. If you are moving it at all at this point, that is a good sign and you will likely have full recovery in 2-3 months.

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.0 out of 5 stars 38 reviews

Swelling and facial asymmetry 2 weeks after facelift can signify a problem.

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After every facelift patients can experience asymmetric swelling, bruising, and numbness, and in rare cases may note weakness in some branches of the facial nerve that control facial animation, such as smiling, blinking, or raising one's brows.

Your surgeon has prescribed steroids, which will help with swelling and inflammation, and may in fact help any motor nerve weakness to resolve more rapidly than it would with no treatment other than "tincture of time." It is quite unusual to have a facial nerve branch or branches cut during surgery, but when this occurs the animation issues can be permanent. As I said, this is indeed rare, so follow your doctor's advice and be patient!

BTW, pain is related to sensory nerves which are ALWAYS cut and irritated during surgery; sensation will improve over several months and reach its maximum at 6-12 months. Be careful of sunburn or frostbite while your facial skin is (partially) numb.

Also, your surgeon IS concerned, but does not seem worried or defensive by your description. Try to achieve an inner calm as your healing progresses. Listen to your surgeon and seek additional opinions if you feel your concerns are not being addressed. Best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 138 reviews

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Swelling 14 days after a facelift is normal; weakness is uncommon

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Residual swelling 14 days after lower facelift is normal, as is some mild asymmetry. The degree of swelling and discomfort you report is not normal, and the nerve-type weakness you report seems to involve multiple facial nerve branch distributions. Your surgeon's treatment of choice - steroids - makes me think that he, too, suspects nerve injury. 

I would consider a follow-up opinion from a facial plastic surgeon if possible.

Good luck!

Laxmeesh Mike Nayak, MD
Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 84 reviews

Post facelift issues

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Prolonged swelling is a possibiblity after surgery and you should follow closely with your doctor to  make sure that your post-op goes smoothly.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

What to do with an unusual swelling after a lower facelift surgery

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Dear milly from Hartlepool,
Regarding your question with prolonged swelling on the left side of face 14 days after lower face lift surgery; this could be a post operative hematoma. The accumulation of dry blood may have resulted in extensive swelling and neurosensory irritation. Wait a week and see how the results of steroid treatment help you. If no improvement is seen, you may need a second opinion. Ask your surgeon what he thinks of the cause and what his long term plans are. Good luck. Sincerely Dr. Kevin Sadati
 

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 101 reviews

Facelift aftermath - what to do...

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In seems as though you are having some prolonged issues after your facelift.  These problems need to be treated and followed.  Be certain to discuss with your plastic surgeon and if you are not satisfied with their answers, please seek a second opinion.  

Jay Calvert, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 25 reviews

Swellinf after face lift

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You need a second opinion with a BOARD CERTIFIED PLASTIC SURGEON(AMERICAN BOARD OF PLASTIC SURGERY)

You need full evaluation and workup

Samir Shureih, MD
Baltimore Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.