I had a facelift, quite a bit of chin work, & a brow lift in October of 2009. It has now been 13 months. Where my glands are located, under my chin, it is still swollen. So, my chin goes partially straight back and were the glands are located they are hard but droopy. Can anyone offer an explanation whether or not this swelling will dissipate and if not what my options might be, like a Botox injection into the glands, etc. My surgeon states that it takes 18 months after a procedure like I had to determine the final results. This seems a bit long to me? Can any professionals offer their professional opinion?
How Long Should It Take to Witness the Final Results of a True Facelift
Doctor Answers (21)
Recurrent swelling along jaw line after face lift will not improve with time
While it is true that healing from a Facelift takes time, healing that takes longer than 6 months is unusual.
It does take time for swelling and tightness to resolve after a Facelift, but I have NEVER seen recurrent swelling or lax skin or recurrent jowls or neck laxity tighten up after they have been seen to be lax or sagging soon after a Facelift.
Most likely from your description, what you are seeing is herniation of the Submaxillary Gland, a gland that produces saliva in the mouth.
This is a very common problem after a Facelift and is very hard if not impossible to correct. As Plastic Surgeons we try to tighten the tissues around the Submaxillary Gland to lessen their appearance, but frequently these efforts fail.
Revision may be possible, but ask your surgeon or seek a second opinion. I am sorry to say but it is not likely that more time will resolve this issue.
Timing of the final results of a facelift.
Swelling after a facelift should be nearly fully resolved within about 4-6 months. This makes it unlikely that you will be seeing any additional improvement in your results. The area you are concerned about is due to ptotic or hanging salivary glands, which are usually tucked up behind your jawbone and hidden. As our tissues age, the glands descend and sit below the lower border of the jaw. Patients may not notice them prior to surgery as the loose skin of the neck is covering them. However when the skin of the neck is tightened and smoothed the rounded contour of the glands is seen. To correct this problem is difficult. Some surgeons resect part of the glands and other advocate sutures to resuspend the glands. Great care must be excersized in doing either as prominent blood vessels and nerves run through the gland and can be injured during the surgery. Don't be shy about consulting with other board certified plastic surgeons to see what might benefit you most.
Time for Facelift Results
Your question is a very good one. The general answer is that recovery from Facelift occurs in various phases, and depends much more on the individual patient than the actual procedure performed. The phases of recovery include: 1) physical signs that other people notice, 2) physical signs a patient will notice but others will not, and 3) psychological recovery. Recovery phase 1) takes anywhere from 10 days to 3 weeks, depending on the patient, the degree of bruising, the extent of swelling. Recovery phase 2) takes at least a year. The process of inflammation that is initiated by surgery leads to a variable amount of firmness (induration), redness along incision lines (which lasts up to 4 months), and numbness in the distribution of the surgery. Recovery phase 3) is the most variable with some patients feeling comfortable right away with their changes, and others taking much longer. This phase of recovery can depend on the support system a patient has, stressors in an individual's life, the encouragement or lack thereof encountered with friends, and pre-existing conditions such as depression. It is important to understand that any claims that a specific branded procedure carries less recovery time has no scientific or statistical validity: some patients bruise for weeks, whereas certain Facelift patients return to work in 3-4 days.
The specific answer to your question is that the firm areas under your chin are likely to be enlarged or descended submandibular glands. Some surgeons advocate the partial removal of these glands, which carries with it an increased risk of injury to a branch of your facial nerve (due to the limited access of the approach). However, the glands can be chemically reduced in size with Botox or Dysport. At 13 months, this may be the wisest and least invasive of approaches.
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Final Results of a True Facelift
Facelift results do not change much after one year; you will normally see a very close approximation of your final result in 6months. However, there are some subtle changes that occur over the next six months that are visible. The problem you are describing is probably ptotic sub-mandibular glands which, as you have read from the other comments, can be a difficult issue to handle but will require a re-operation to fix.
Final facelift results
You are seeing the final results already. No further improivements can be expected. Submandibular glands are very controversial and either need to be accepted and left alone (most doctors opinion) or they need a redo surgery and partial excision but this is not without recovery and risk.
How Fast Are Final Results
You should be seeing the final results at 13 months. A facelift should, as with all facial procedures, be a gentle technique based upon the strong repositioning of the underlying support tissue and then the re-draping of the overlying skin with essentially no tension.
Our patients are socially presentable with minimal cover-up in as little as 5-7 days. Rarely do our patients requires any pain medication and one can shower the next day. There will be a slower resolution of mild swelling -all for the better- over a few weeks. At the 2 month interval virtually all areas are stable and resolved.
If there are areas of concern and perhaps prominent glands that are present, this needs to be assessed in detail to better determine the best treatment option. It is in general inadvisable to try to resect or suspend prominant glands.
Persistent swelling under neck one year post face and neck lift, what to do now?
Dear Johnadler from San Clemente, CA
In my opinion what you are dealing with is called a ptotic or droopy submandibular gland (salivary gland) which were not noticeable prior to surgery since loose neck tissue was covering it. Once you had your face and neck lift then skin became smooth and that gland appeared more prominent. Prominent submandibular glands are difficult problem to treat. Some surgeons partially remove them, but that involves major risk such as nerve injury to dry mouth. I do not believe that you should be experiencing any swelling by now. Please do not Inject Botox into it that is a waste of money. If you would like, I will be happy to evaluate you since you are in my area. best of healing for you.
13 months after facelift surgery I would expect little improvent in your result. Consult with another surgeon for examination and a discussion of treatment alternatives.
Facelift after 1 year is healed.
We say that normally it takes 12 months for the facelift to be healed. You may want to get a second opinion from an experienced facelift surgeon.
How long does it take to see facelift results?
Facelift results should be immediately noticable, with final results seen about 4-6 months after the procedure. The bulges you describe are prominent submandibular glands--the treatment of these is challenging, and you should seek out a surgeon who routinely performs such treatment, which can include suspension or partial resection of the glands. The main risk with these procedures is bleeding, as there are large vessels intimately associated with these submandibular glands.
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.