Hard Swelling and Brusing on Lower Cheek After Face Lift Three Weeks Ago

Swelling at 3 weeks is not unusual. At this point you likely have around 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.

This area is likely an old fluid / blood accumulation that has settle into this lump. A 3 weeks, it is possible that this fluid could be aspirated but likely it is hard and full of inflammatory tissue and collage build up. Steroid injections would be my first thought along with pressure dressings and judicious taping.

Thank you for your question for sharing your concerns with us. Swelling and firmness in the tissues will return to normal as time passes by. Between the first and second week, much of your swelling and bruising will dissipate.  This will be prolonged in the setting of a hematoma.  Hematomas vary in presentation.  Large ones that may compromise the tissue viability or the surgical goals should be evacuated.  Smaller ones may be observed and can resolve on their own with time. Lymphatic massage maybe an option to help clear the swelling/bruising and firmness at a faster pace. I would make sure that you continue to follow up with your plastic surgeon during this period of time.

Swelling and bruising is normal after a facelift and, on average, lasts about 14 days. Of course, that is an average and there are people on either side of that number. There are younger patients who only bruise for 5-7 days and there are older individuals who bruise and swell for 6 weeks but on average, 14 days is what most people get.The amount and duration of the swelling and bruising depends on several factors such as diet before the procedure, medications, herbal supplements, activity after the procedure, age (vessels are more fragile as one ages), the extent of the procedure, other concomitant procedures adding to the bruising, habits such as smoking, and envirnomental factors such as heat, excessive sneezing or coughing, etc. You can help bruising by increasing your intake of pineapple, arnica montana, and papaya extract; all of these have been shown to minimize bruising formation. To improve an existing bruise, consider lympatic massage by your surgeon's office, topical arnica montana, and topical vit K in addition to increasing intake of green leafy vegetables. Hematomas, a collection of blood under the skin, even when cleared still leaves behind a residual amount of blood under the skin and can prolong the bruising period. If there is a small hematoma, you can let it resolve on its own but this will take about 6-8 weeks to resolve and may require some steroid injections afterwards.  In the end, bruising always goes away, but can be a nuisance when it doesn't resolve as expected. Good Luck!