Noticing Pulled Up "Muscle" Cords After SMAS, Will It Improve? (photo)

Had smas lift 6 mos ago. I still see pulled-up muscles "cords" under skin. One side since surgery--pic with scar. As swelling has decreased, they're now noticeable on BOTH sides, especially in certain light--curtain pic. Looks like pulled up "austrian shade" :) My PS says they'll "soften" over time. What caused this? I don't see similar smas pix on this site. Is this a smas lift gone bad? How long do you think "over time" is? Will it ever go away? I'm starting to get embarrassed :(( P

Tags:

Comment on this

6 Doctor Answers | Asked by Seedfiddle Coach in Sonoma, CA

Doctor Answers (6)
Community Comments (0)

Cords after a SMAS facelift

What you are seeing is likely small areas where there is more swelling around sutures that were placed and there is a kind of undulation in the area. Usually they all go away. If you are bothered by them you coudl have small amounts of filler placed that will hide them while they get better. You can use a hyaluronic acid filler or Sculptra. As the cords get better on their own the filler will slowly dissolve and all should look better.

Irregularities after a facelift

Morning Seefiddle, I wouldn't say you PS made any errors but it can be improved if not resolve on it's own over the next 3 months or so. It's difficult to say without an exam but based on what I can see from your 2 wk post op it looks like the anterior and superior limit of the dissection of the cheek area was limited to about where that depressed cord appears. If the irregularity doesn't improve on it's own, and it probably will, you can do a small... more

Chase Lay, MD

18 reviews

Bay Area Facial Plastic Surgeon

www.chaselaymd.com

Visible "cord" after SMAS lift

Dear Sir, I have had extensive experience with all types of ways to lift and tighten the SMAS. From your picture this appears to be a suspension type of suture. I surmise this from the directional vector of this pull. Ask your surgeon if he or she used a non dissolving suture devise? I'm betting that your "cord" is seen to your mid face soft tissue and suspended to the temporal fascia. By the way, if this is the case, they can be removed .

Pulled Curtain after SMAS Facelift

If there was a permanent suture used, this may need to be removed. However, tissues and sutures, even if permanent, always relax to some degree. The tissues cannot be held indefinitely in place in the facelift. Therefore, this works to your advantage in a situation like this. If the band or curtain or rope persists for a year, filler or fat grafting for camouflage is a reasonable alternative. Kenneth Hughes, MD Los Angeles, CA

Unusual Appearance following SMAS Facelift

Final Healing Following SMAS Facelift is Progressive Over Many Months Although 6 months have passed it is likely that it will improve at least somewhat over the next 6 months. The type of swelling typical of the photo you showed is often due to induration (chronic edema) which may be due to the fact that this is where most of the SMAS plication or suturing took place. Without seeing your operative note it would be impossible to tell, but a good question for your plastic surgeon. If it... more

Noticeable contour irregularities after a smas facelift

Those areas should continue to resolve over time. They most likely represent directional vectors; that is, areas that were cut and lifted from the smas layer. Often massaging those areas can help or you may need some fillers to mask over those areas. Fat augmentation or sculptra can often correct those areas.