Lumpy Neck, Visible Swelling in Cheeks After Facelift- Is It Permanent?

It's been 4.5 weeks since my facelift. My neck is lumpy and a rather large scar is visiable. If people look staright at me, they cannot see since it's under the chin but if I turn my head they can see it. My lower left cheek has a VISIBLE walnut size swelling. And my left cheek has a once-inch veritical visible "thingy" (looks like a smooth rope under the skin). I'm seeing my plastic surgeon in a few days but will these go away or I am stuck with them forever?????

Doctor Answers (16)

Lumpy Neck and Cheek 4 Weeks after Facelift

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    All of these bumps may be normal swelling, but they should be evaluated for fluid collections or hematomas as well as fat necrosis and suture reactivity or tissue bunching.  Kenneth Hughes, MD Los Angeles, CA


Los Angeles Plastic Surgeon
5.0 out of 5 stars 194 reviews

Lumpy Neck, Visible Swelling in Cheeks After Facelift- Is It Permanent

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It sounds like there was a large amount of swelling and possibly bleeding during your procedure. That can cause what you are seeing and in time should get better. There might be some shots like kenalog that might help in some cases too.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.0 out of 5 stars 6 reviews

4.5 Weeks After a Facelift

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It is far, far too early to make a judgment on your final result.  You can expect some degree of incisional redness, in addition to areas of swelling which are most likely related to lymphatic edema.  Gentle finger tip massage, and more importantly.... time are likely to help.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
5.0 out of 5 stars 32 reviews

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Swelling After Facelift

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Hello,

  One month after facelift surgery seems like a long time.  However, it is not until six to twelve months after surgery before all of the swelling is gone and the scars have matured in appearance. 

  It is common to have concerns similar to yours after this type of surgery.  With time and massage, many of the firm areas soften and incisional scars fade away.  I would not become preoccupied with thoughts of a revision only a month after surgery. 

  I do agree that visiting with your surgeon and communicating your concerns are a very appropriate and important steps.  Your surgeon has specific knowledge of your procedure and should be able to guide you to the right postoperative strategy to manage your concerns.       


Hope this helps.

Christopher Kolstad, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 33 reviews

4.5 weeks post-op

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Each situation is unique and only your surgeon knows the specific details of your procedure and should be the person commenting on post-operative questions such as this

Sam Naficy, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 137 reviews

Early face lift results.

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Rarely patients develop a small collection of blood that forms a clot. One has to wait for that to become liquid so that it can be aspirated. The walnut size lump could be one of these collections which could be aspirated with a needle in the office. See if your surgeon can help you with that. If the blood clot is not aspirated it will turn into scar tissue but with time and massage it should go away.

Farhad Rafizadeh, MD
Morristown Plastic Surgeon
5.0 out of 5 stars 19 reviews

Lumps after facelift

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I don't think the things you are describing will be permanent. Your surgeon will be able to help you the most since he/she knows what was done. Hang in there.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 23 reviews

4.5 weeks is too early after a face lift to see final results

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4.5 weeks is still an early result.  There may be small pockets of fluid that will resolve with time and massage.  Please have a frank discussion with your surgeon.

Raghu Athre, MD
Houston Facial Plastic Surgeon
5.0 out of 5 stars 33 reviews

4.5 weeks is an early result!

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At  I month you likely have some small resolving collections  of blood called hematomas. The lump under your jaw could be your submandibular  gland. Sometimes deferring the neck aggressively will unmask these normal structures.  Your surgeon may do some injections  of dilute kenalog to help with some of these issues. You should be showed how to do some manual massaging to perform several times per day. Good luck 

Charles Virden, MD
Reno Plastic Surgeon
5.0 out of 5 stars 60 reviews

Lumps and swelling 5 weeks after facelift.

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As my colleagues have answered, 4 1/2 weeks to 5 weeks after surgery is still fairly early in the overall healing process, which will take 6 months or longer to reach its full completion and your "final" result. (I put final in quotes because, of course, you will still be aging and no result is truly "final").

Your walnut-sized swelling could be a collection of blood or serum that has (mostly) reabsorbed, leaving a lump of subcutaneous scar fibrosis. This usually softens and diminishes, but may not completely go away. Massage, infrared and ultrasound treatment, and perhaps steroid injections can help this. In the unlikely event this is still a fluid collection, aspiration is possible. Your surgeon should be able to help identify this.

Depending on its location, sometimes swelling just below the jawline can be a protruding submaxillary gland, but you described your swelling as on your cheek, not below it.

The "smooth rope under the skin" you describe may be an internal plication (folding or tightening) suture that many plastic surgeons use to improve the appearance and longevity of results with our facelift patients. Sometimes these tightening sutures below the skin can be visible, but this also usually diminishes as swelling resolves, and the suture dissolves, stretches, or loosens (but this depends on the type of suture used--I use Goretex because it is inherently "stretchy" and has porosity that allows tissue ingrowth, yet is still permanent and does not dissolve). Your surgeon can address this concern as well. BTW, this is one of the concerns with "threadlifting" since the barbed sutures must engage with the skin to "pull" it tighter. If too superficial, the barbs can be felt, seen as a "rope" or tether, and then the barbs break off or bend back and the "lift is lost. Most reputable plastic surgeons do not perform or have abandoned threadlifting for facial rejuvenation.

Your scars are permanent, so at this point you have to trust that your surgeon used discretion in choosing incision placement, and fine technique in closure, so that over time the scars will soften and fade to near-invisibility. Avoiding ultraviolet (sun or tanning bed) for up to a year after surgery is critical to prevent hyperpigmentation (dark brown discoloration) of your scars.

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 118 reviews

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.