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What Can Be Done to Reduce Swelling and Lumps After Lower Facelift and Platysmaplasty?

I had a lower facelift and platysmaplasy 9 weeks ago and still have swelling,numbness and lumps. Can I use ice and heat alternately? Can is use Bromelain and Arnica again to help? Is there something else I can do or take? Thank you for any advice that will help.

Doctor Answers 16

Swelling and lumps 9 weeks after lower facelift and platysmaplasty--what to do?

At just over two months post-op lower facelift and platysmaplasty, numbness is entirely expected and should gradually return to a new "normal" over several months, and reach maximum improvement at about one year. Scars also take 6-8 months (or longer) to completely soften, settle, and fade maximally, but you must avoid ultraviolet exposure (sun AND tanning beds of any kind) until your scars have lost all pinkness in order to prevent unwanted hyperpigmentation.

Swelling and lumpiness is variable with each patient, and is worse if there was some under-the-skin bruising or oozing in the early post-op period. This can occur with vomiting, increased activity, or elevated blood pressure from any cause. Whatever swelling has turned into subcutaneous scar tissue can be reduced by external massage therapy, external ultrasound treatments, and perhaps gentle infrared treatments, (all performed in our office by our massage therapist, and included in the cost of our facelift procedures). You can do this on your own, but don't think you can reverse this overnight--a regular routine of massage and continued head elevation above heart level will help this resolve soonest. Scarring or excessive lumpiness that persists can be further reduced by judicious steroid injections by your surgeon.

At this point in time, Arnica and Bromelain are no longer helpful (though I use Arnica in my patients immediately post-op, and feel that it is a benefit in reducing bruising and aiding re-absorption). Be patient, you still have a way to go to see your final results.

Minneapolis Plastic Surgeon
5.0 out of 5 stars 196 reviews

What can be done to reduce swelling and lumps after lower facelift and platysmaplasty?

Hello! Thank you for your question! Numbness after any surgical procedure is expected for several weeks to months following. As the nerves to the area are traumatized and will then experience a temporary neuropraxia, a transient loss of nerve conduction. This usually resolves over the next 6-12 weeks, but depending on the procedure performed, sometimes much longer. Typically this should resolve by 1 year. As it goes past this date, the likelihood of the sensation returning is small. However, it can take up to 2 years. If no return from there, it is unlikely to return. It should be discussed that persistent sensory changes may develop following any surgical procedure. Warm compresses and massage often help.  Ultrasound to the areas are also helpful - discuss treatments with your sugreon.

The usual signs of the nerves regenerating and neuropraxia resolving is itching, followed by a burning sensation and then occasional sharp, shock-like pains. These will be normal to experience, and actually a promising sign. Usually, normal sensation returns, but is is also possible to have decreased sensation or even increased sensation to the areas affected. Re-educating nerves postoperatively is often helpful and will allow proper instruction for the affected sensory nerves - methods include using different textures to the affected areas when showering, bathing, applying lotion, etc. If bothersome, there are some medications that may be helpful, including Neurontin for pain for hypersensitivity. You can try various textures such as washcloths, loofahs, cotton sheets, etc. Massaging the areas is also beneficial for the incision to make the finest scar possible. The last place to regain the sensation will be directly adjacent to the incision/scar as the nerves will make its way from the periphery to this location. If continual pain arises, evaluation is warranted. After ruling out other causes, one rare explanation may be that a neuroma has developed and may require surgical excision. This is very unlikely unless a large sensory nerve has been transected inadvertently during the procedure. Hope that this helps! Best wishes!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 14 reviews

Swelling and lumps after lower facelift and platysma plasty

Swelling and lumps after a lower facelift and a platysma plasty are usually with in normal limits and are part of the course of  healing. Best to check with your original surgeon to see how they handle these issues. Bromelain and Arnica will probably not help 9 weeks after the surgery. Ultrasound,  steroid shots and a low-salt diet will all help with these issues. Most of these irregularities should resolve over time in the next few months. For many examples, please see the link below to our facelift  photo gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
4.5 out of 5 stars 72 reviews

Swelling and numbness associated with lower facelift surgery

Dear Lower Facelift Patient from New Jersey,
Healing process varies person to person. As swelling subsides after any facelift surgery, sensory nerves begin to function, therefore numbness will subside. Nine weeks post op majority of swelling associated with facelift surgery should subsided, and the remaining will resolve over next few months. Massage and external ultrasonic treatments are good options. Good luck and good healing.

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

Treatment of lumps and swelling in face

At nine weeks having some swelling and some lumpiness is not that unusual. This usually gets better with time, but massage may help.

Steven Wallach, MD
New York Plastic Surgeon
4.0 out of 5 stars 22 reviews

Reduction of swelling and lumps after lower facelift and platysmaplasty

You are still very much in the recovery period post lower facelift and platysmaplasty and I would suggest that everything you are experiencing is entirely normal. I would expect a gradual improvement over the next 3-6 months providing that you massage and moisturise the areas, its imperative for nerve recovery that you touch the areas and massaging will help this greatly.

Arnica creams are good and cool packs are beneficial so it sounds like you are doing all the right things!

Make sure you use high protection suncreams when out in the sun to avoid the scars burning.

Wishing you a speedy recovery

Be patient.

The numbness, firmness and irregularity usually resolve in about six months. Gentle message is what I recommend to my patients. If the scar under the chin is thick, I have my patients use Scar Recovery Gel by Skinmedica. It is messaged into the scar twice a day and I've seen nice results with that.

Stephan Finical, MD
Charlotte Plastic Surgeon
5.0 out of 5 stars 6 reviews

Smoothing lower facelift results 9 weeks after surgery

About 2 months out from surgery. Ice and heat would not be effective. Bromelain and Arnica are also outside the window of effectiveness 2 months out. I do believe massage and moisturizers are effective in positively impacting results. If the lumps are sutures, these should disappear within a month and will respond to moisture and massage. If it is 4 months and you still have lumps and irregularities, you should discuss with your surgeon what he/she thinks is going on and what can be done. If you are not satisfied with the response and you are concerned, seek a second opinion. Best of luck!

Michele A. Shermak, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 32 reviews

Swelling And Lumps After Lower Facelift and Platysmaplasty-Try Massage

Thank you for your question. Be sure to see your surgeon for advice. In my experience minor swelling and lumps after Lower Facelift and Platysmaplasty can respond to warm soaks and massage. Ultrasound can also help.

It is important to be examined by your surgeon to make certain that there is not a collection of blood or hematoma.

Minor swelling and lumps should resolve with time.

Swelling and numbness is to be expected- this is what helps

Here is what I have found to help in many cases:

Localized lymphatic massage - your surgeon will demonstrate for you

Continued head elevation

Ultrasound treatment 

Low Salt diet 

No heavy lifting or intense exercise

Use of injectables such as steroids are contoversial and should be discussed with your surgeon


I don't think alternating ice and heat, Arnica or Bromelain will be of benefit at this stage

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 76 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.