Steroids Injections to Reduce Swelling After Facelift?

Question

Postop 7 weeks facelift, and necklift. Still have swelling near earlobe. My PS wants to wait 6 more weeks, before steroid injections. What is you opinion, should i give it more time to heal? Are there any side effects of steroids?

Stephen Prendiville, MD · Answer

Your surgeon has given you very sound advice. Steroid injections can be useful in areas of excess incisional inflammation, but should only be used when acute and subacute inflammation have subsided. The form of steroid used (usually kenalog) works via a catabolic mechanism, breaking down tissue. This catabolic nmechanism is non-selective and can affect normal tissue also. Allow a tincture of time to pass and don't watch the water boil!

Jonathan Kulbersh, MD · Answer

At 7 weeks post-op, it is common to still have
some swelling. Swelling may not fully resolve for several months, although most
of my patients find that the majority of swelling dissipates within 14-28 days.
Steroid injections should not be rushed into, as they can cause skin and fat
atrophy that may lead to permanent depressions. My advice would be to be
patient, and if you still have significant swelling after another six weeks then
see your surgeon again for a follow-up. I hope this helps.

Young R. Cho, MD, PhD · Answer

Thank you for your question for sharing your concerns with us. Swelling and firmness in the tissues will return to normal as time passes by. Between the first and second week, much of your swelling and bruising will dissipate. It may take more than a month or two for your tissues to fully soften and any residual swelling to resolve. Lymphatic massage maybe an option to help clear the swelling and firmness at a faster pace.  I would make sure that you continue to follow up with your plastic surgeon during this period of time and agree on waiting for another six weeks before contemplating steroid injections.

Richard J. Bruneteau, MD · Answer

It’s not unusual for patients to experience significant
swelling following facelift surgery. In
the vast majority of patients, swelling resolves with the passage of time. For this reason, steroid injections aren’t
usually indicated to treat this problem. Steroids
are occasionally indicated to treat adverse scarring in the late post-operative
period. Unfortunately, steroids may be associated with skin atrophy, scar
spread, hypopigmentation and redness. For these reasons, steroids should be used with caution when treating
adverse scarring following facelift surgery.

Ronald J. Edelson, MD · Answer

I do not perform steroid injections do reduce swelling.  At your point, it is not surprising that you may have some swelling or lumps.  Your surgeon should check to make sure there are no problems, but I would not rush into steroid injections.  They can cause thinning if the skin and atrophy of the underlying tissue.

Lawrence Kass, MD · Answer

I use steroid injections to treat scars after facelift surgery. that said, at seven weeks your incisions are still going through normal healing and a normal remolding process. I think you should wait longer and use scar cream conscientiously before considering steroid injections.

Babak Azizzadeh, MD, FACS · Answer

I generally do not like steroid injections for reducing swelling as it may cause atrophy of the skin and fat in an unpredictable manner. Instead, I suggest and prefer using 5FU/steroid mixture only for excessive scar tissue formation on rare occasions, which does not cause atrophy.

Larry S. Nichter, MD, MS, FACS · Answer

Short answer: Give it more time to heal

	Steroid injections are not commonly used for postoperative swelling. I think your plastic surgeon has given good advise to wait. Steroids like most medications have side effects and complications  such as hypopigmentation, fat atrophy, increased suggestibility to infection, potentially wider scars, and so on.

Kevin Sadati, DO · Answer

Dear Facelift patient from Tennessee,
	I agree with your PS regarding your treatment. Conservative treatment is the right choice for you at this point. Treatments like scar creams and topical steroids on incision lines, as well as warm pad with tissue massage will help to reduce scar formation and to reduce tissue swelling. Please be patience and follow your surgeon’s advice. Good luck and good healing

Ron Shelton, MD · Answer

Wound healing takes longer than most people realize. The body has amazing healing powers and it is wise not to rush it at times. Overzealous treatment to reduce swelling could increase the risk of improper wound healing and even infection. Your surgeon will know the best time to intervene.

Steroids Injections to Reduce Swelling After Facelift?

Answers (20)

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