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Bruising or Hematoma After Facelift?

asked 3 years ago by jpierce1 in cocoa beach fl us
Latest answer by Larry S. Nichter, MD, MS
Question viewed 13,536 times
Tags: face, bruising

I had a facelift on 4/13. All seemed fine, then about 4 days ago, I developed a very dark bruise or hemotoma on my left cheek. There's no pain, but should I be concerned or is this part of the normal healing process? Thanks.

23 answers to Bruising or Hematoma After Facelift?

+5

Please see your surgeon!

Dear JPierce Some times patients are very considerate of their busy surgeon's: "I didn't want to bother you so I am waiting for my one week appointment." Please be aware that this hematoma potentially constitutes a threat to the facial skin over the area of the bruise. If you have not seen your doctor and you are reading this, I urge you to pick up your phone and call your surgeon. I assure you, your surgeon wants to hear from you. He or she will want to see you immediately... more
Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon
+4

Some bruising, some skin loss, and a possible hematoma

It's difficult to know without examining you, but from your photo you certainly have some skin loss and some bruising, and my guess is a small hematoma as well. I would see your surgeon ASAP as I am sure he would want to treat this in some manner, be it local wound care or drainage of the hematoma. In most cases, the good news is that after proper wound care and time, it should heal well and look acceptable compared to your other side.
Shahram Salemy, MD

Seattle Plastic Surgeon
+4

Looks like small hematoma with a little skin loss.

Hi.   From the one picture and from the timing, I think you have a hematoma that should be looked at right away, because it could affect the result.  I cannot tell you what treatment you need (most commonly, the blood clot is removed under anesthesia), but see you surgeon right away!
George J. Beraka, MD

Manhattan Plastic Surgeon
+3

See your surgeon

While one photo clearly does not tell the whole story, I do think that you should see your surgeon for advice. It appears that the skin at the top, just in front of the ear, is looking compromised. Topical antibiotics, or other treatment may enhance your outcome.
Darrick E. Antell, MD

Manhattan Plastic Surgeon
+3

Cause for concern

Of course you should be addressing these concerns to your own surgeon. From your photos, there appears to be an area of dark skin above your ear where your sideburns should be. If it is black, this is not normal. Your skin of the cheek area in front of your ear is quite dark and could very well indicate a hematoma or at least significant bruising that could compromise the viability and healing of the overlying skin. You should have your surgeon look at this as soon as possible since remedies... more
Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon
+2

Minimizing Bruising and Swelling Post Facelift

I think one of the most important things is to have the patient stop Aspirin, Advil, Motrin, and fish oils pre-operatively as well as atraumatic technique on behalf of the surgeon. I also add platelet rich plasma (PRP) which is an autologous internal glue to help minimize bruising and swelling in my patients. Bruising and swelling is not uncommon, however, if you have a hematoma that is significantly different. It needs to be acted upon and evacuated immediately. This is something that is... more
Rod J. Rohrich, MD

Dallas Plastic Surgeon
+2

Face Lift Bruising, Bleeding, or Hematoma

Any bruising, bleeding, or hematoma after face lift surgery should be immediately be known by the plastic surgeon. While a certain degree of bruising or bleeding from the incision / stitches is expected, a collection of blood (hematoma) underneath the skin should be treated right away. Hematomas are generally drained, or observed if very small. Hematomas after face lift surgery are more common in men and patients with high blood pressure. Blood thinners, aspirin, ibuprofen, and herbal... more
Houtan Chaboki, MD

Washington DC Facial Plastic Surgeon

www.potomacplasticsurgery.com

+2

Hematoma? Only Your Surgeon Can Tell

I agree with other posters that the 1st thing you should do is go and see your surgeon for any concerns. Secondly, although bruising is present, a hematoma does not appear to be present in this photograph. Lastly, the dark appearance of the skin beneath your sideburn suggests a small amount of skin flap necrosis. Although your surgeon is likely to take a very conservative approach with this issue, an absorbant dressing known as Polymem(3M) may be helpful. Treatment with Polymem is as... more
Stephen Prendiville, MD

Fort Myers Facial Plastic Surgeon

www.drprendiville.com

+2

Facelift Complication

One picture does not tell the whole story nor is it as reliable as a formal examination. The dark / blue coloration of the right side suggests a small blood collection under the raised skin flap. if the skin is under any pressure, the collection would be best drained to reduce pressure on the skin which may lead to loss of blood flow in the skin. More worrisome, you appear to have partial loss of the skin in front of the upper portion of the ear. This needs to be dealt with immediately... more
Peter A. Aldea, MD

Memphis Plastic Surgeon
+2

Likely a bruise

This dark area looks like a bruise.  A hematoma may be possible but it is associated with localized fullness, pressure/tightness, and pain or discomfot.  Make sure you keep in contact with the doctor. sek
Scott E. Kasden, MD

Dallas Plastic Surgeon
+2

Get this checked

In order to protect the skin, this needs to be checked. There are some simple things that can be done to help your situation that may have long term consequences. You want to prevent the skin from breaking down and forming scars. If there is a hematoma, the blood can be removed to reduce the effect on the skin flap. These type of postoperative occurrences can happen but they need to be addressed as soon as possible. If you do not get an immediate response from your surgeon then you... more
Marcus L. Peterson, MD

Saint George Plastic Surgeon
+2

Call your doctor to check for hematoma after Face Lift

Bruising is common after facelift; however, your history and picture suggests a hematoma. Typically, bruising after face lift is apparent in the first day or two. The acute onset of bruising at day 4 suggests that you may have had some bleeding and a hematoma has formed. This can happen if your blood pressure has been elevated during activity, or a small blood vessel may have opened. It is important to address this immediately. If you have a hematoma, your doctor can easily drain the blood... more
Brooke R. Seckel, MD

Boston Plastic Surgeon

www.drseckel.com

+1

See your doctor about severe bruising after facelift

Your doctor will want to see you and examine your face. It could be hematoma, and it is important for your doctor to verify that it is not reducing blood flow and healing so that you do not have skin compromised. Avoid the following things to minimize bruising after a facelift: Aspirin (and Aspirin-containing medications, before and after surgery) Any blood-thinning medications Fish oils Herbal supplements Vitamin C and E supplements Heavy lifting... more
Larry S. Nichter, MD, MS

Orange County Plastic Surgeon
+1

Facelifts and Bruising or Hematoma

This is something that your surgeon should be made aware of. It is always difficult to tell just from a photo, but your skin appears compromised and it looks like there will be some skin loss. The purplish discoloration coud just be some bruising (some blood absorbed into the fat layer below the skin like water in a sponge), but I also suspect there is some amount of hematoma (an distinct colection of blood below the skin). A hematoma will cause bruising of the overlying skin. Hemotomas can... more
Braden Stridde, MD

Federal Way Plastic Surgeon
+1

Facelift Hematoma

Most hematomas occur within 24 hours of surgery. This could be a hematoma which developed late as a result of high blood pressure, excessive sneezing, too much bending over, etc. If it's a hematoma, conservative treatment with daily drainage at the bedside until it resolves is recommended. If there is no drainage when a needle is inserted, it is likely a bruise.
Anita Mandal, MD

Palm Beach Facial Plastic Surgeon
+1

New onset bruising 4 days aftr facelift

The first thing that you need to do is see your facelift plastic surgeon.   It is impossible to assess what is exactly going on with just one photo.  My concern, as elucidated by my colleagues here, is that you may have a small hematoma.   This warrants evaluation by your surgeon.
C. Bob Basu, MD

Houston Plastic Surgeon
+1

Bruising or Hematoma after a Facelift

It appears as though you have a small hematoma that has affected the healing of your skin near your ear.  These hematomas can result from sudden increases in blood pressure and most commonly occur within the first day or two after surgery, and at about 10 days after surgery when small clots that sealed blood vessels dissolve with increased risk of bleeding.  Your photo shows some darkness along the edges of your incision near your ear and hairline meaning that the volume... more
Daniel Shapiro, MD

Scottsdale Plastic Surgeon

shapiroplasticsurgery.com

+1

Facelift bruising

Facelift bruising is common after surgery. As for a small hematoma it is always possible, but without an exam it is hard to say.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Bruising or Hematoma after facelift

It is very difficult to determine what exactly is the cause without knowing more and without having the exact timing since surgery. Based on the picture if the symptoms or discoloration occured immediately after the surgery it may be related to a hematoma or somewhat comprimised blood supply to the skin. In that case, you would need to return to your doctor and he may need to either evacuate a hematoma, loosen the dressing, stop using icing or cooling if you have done so, or may ask... more
Boris Volshteyn, MD, MS

Reno Plastic Surgeon
+1

Bruising after facelift

This appears to be a prominent bruise following surgery.  There may have been a small hematoma, but there is nothing surgical to do about it unless it is more than 10 ml of blood, which does not appear to have been the case.  Some light massage of the area may help.  It appears you may have a small region of skin slough in the region anterior to your ear.  Keep close follow up with your surgeon.  Hopefully, this will all heal without any long term issues. ... more
Jason R. Hess, MD

San Diego Plastic Surgeon
+1

Bruising or hematoma after facelift

Did you mean 3/13 Saturday? Or was it a year ago in April???? Appears as a small hematoma. Contact the operating surgeon ASAP. Regards From MIAMI
Darryl J. Blinski, MD

Miami Plastic Surgeon
+1

Hematoma after a facelift

Your lateral photo doesn't show if this is just bruising in the skin or if there is a bulge suggesting a hematoma. Your skin looks compromised below the sideburn and so you should see your surgeon asap for an evaluation. A hematoma should be evacuated.
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon
+1

Good Post-Operative care is important after Facelift

From the picture it appears that you have a small blood collection under the skin that may be liquid or hardened. If it is liquid it should be extracted with a needle as it will increase the rapidity of your healing and bruise clearance. Also the skin at the top of the incision appears a little scabbed and lacking blood supply. It is important to have good local wound care cleaning it and applying antibiotic ointment to enhance your outcome.
Andrew Jacono, MD

New York Facial Plastic Surgeon

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