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Can skin adhesions after Facelift be addressed laparoscopically?

after face lift and hematoma my skin is still matted down(3.5 mos post op). usedcsteroid inj and massage and ultrasound but my skin is still matted down in the lower cheeks, smile line. having the skin relifted and redraped sounds like a huge procedure. is there a way to do this laparoscopically? i would also like to do fat grafting. can fat grafting help release some skin?

Doctor Answers (10)

Facelift problems

+1
As difficult as it is, I would suggest you continue to be patient and allow the healing process to continue.  Things will soften and improve for another three months at least.  Although an endoscopic approach might seem attractive, I do  not think it would offer any benefit over using the incisons you already have.


Boston Plastic Surgeon
5.0 out of 5 stars 16 reviews

Face lift complications

+1
I'm sorry to hear about your difficult postoperative course.  Like other comments here, I agree that you are still in the midst of healing after your surgery and it is too early to give a final evaluation of your results and consider revision.  Let things be for at least another 3 months and then revisit with your surgeon who may have several options for you.
Best wishes!

Adam David Lowenstein, MD, FACS
Santa Barbara Plastic Surgeon
5.0 out of 5 stars 23 reviews

Scarring from face lift hematoma

+1
Thank you for your inquiry about healing after a hematoma from a face lift.

This is a discouraging complication.
But it is too early to consider revision - it will disrupt your healing and a second operation will be needed. 

You should wait at least 6 months. As for laparoscopic release - it can be done but is usually better to use the existing incision and redrape the skin - release of the scar may not be all that is needed.

yes, fat injections can be done at the same time. They will not release the skin but can help to smooth it. 

I do recommend using as little steroid as possible - although it helps the swelling now, I have found that it will loosen the face lift result itself - and the face lift may need to be redone on that side. best wishes.

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.5 out of 5 stars 21 reviews

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Can skin adhesions after a facelift be addressed laparoscopically?

+1
At a few months after a facelift with the complication of a hematoma, you are still healing. It is possible the area may feel smoother with time. Give yourself time to heal before considering another procedure.
A laparoscope does not apply to your
face.

Suzanne Kim Doud Galli, MD, PhD, FACS
Washington Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Skin adhesions after Facelift

+1
Dear angel, thank you for your question.Swelling after a facelift may persists from weeks to months, causing bumps or asymmetries to appear. In San Diego, we monitor our patients closely for one year to address any issues. Follow up with your surgeon to check if this is swelling versus something else and if treatment is indicated. Best of Luck.

Roy A. David, MD
San Diego Facial Plastic Surgeon
4.5 out of 5 stars 19 reviews

Facelift

+1
Thank you for your question. While it is understandable that you would like to get a revision right away the best thing to do is to let the scars mature and see what your end result is before considering revisions. I would recommend waiting anywhere from 6 months to a year before attempting a revision. Laparoscopic or endoscopic approaches are possible, but it would be best to go through the old incision for better visualization.

Arun Rao, MD
Tucson Plastic Surgeon
5.0 out of 5 stars 5 reviews

Adhesions after facelift surgery

+1
Don't jump the gun on a revision, by whatever technique.  6 months is the usual waiting period.  There are many things that can be done until that time that will reduce or minimize adhesions.  It sounds as though you are doing some of them.

When all the dust has settled, then it's time to decide what, if anything, needs to be done.  There are many, many different techniques to address irregularities, from minimally invasive interventions to redo facelift procedures.

Hopefully you will be like the majority of patients with your issue and in three months' time your issue will be resolved!

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 94 reviews

Facelift stuck to deep tissue.

+1
I have treated several patients who have had this and fortunately I have not. I do not advocate steroids for this since it dissolves the fat and makes it worse. I have treated   patients who had this from the "week-end facelift" by doing graft of tissue from the abdomen the size of a pancake of deep tissue without the skin and it worked well.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

Flap adhesions after facelift

+1
this is actually quite a common occurence. Early in facelift recovery most patients will notice lumpiness or lymphatic swelling. This usually resolves completely given time, heat, and massage. Only in one patient in the last 50 facelifts have I encountered this beyond 3 months and it settled will with steroid injections. These can cause localised telangectasia or spider veins over the treated area, but these in turn are removed with pulse dye laser treatment. The main concern with elevation and revision of the flap is that the same issue may reoccur. I would not perform this at this relatively early stage. There is no need to do this laparoscopically as skin elevation can be performed with a flap microcannulaunder direct vision. The same issues of recurrence may occur. There is no place for fat injection. I would suggest working with your facial plastic surgeon and trusting his or her judgement. Certainly at 3 months you are young in your facelift recovery. Good luck and best wishes.

Dominic Bray, MBBS, FRCS
London Facial Plastic Surgeon
5.0 out of 5 stars 41 reviews

Skin adhesions after facelift are rare.

+1
I'm not really sure what you're referring to but perhaps the skin is stuck to the deeper connective tissue. I well recall having met with the facelift and it is not commonly discussed as a complication. I guess is that the skin will need to be elevated in redraped if this is the case. I don't think fat grafting will have a significant role in treatment of that specific problem.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 8 reviews

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