I have some very visible scar puckering after neck and jowl lift. Is this normal?

I'm 8 days post-op after having a neck and jowl lift. The incisions in front of my ears are healing puckered like a draw string purse. I wear short hair and don't have enough hair to cover it. Is there a way of loosening the pucker marks? What about re-incising the scar, laser therapy or massage therapy to loosen up the adhesions? Also the scars behind my ears are long thick and very raised. Is this normal?

Doctor Answers 9

Early concerns after neck lift and facelift are normal

All the changes you are describing are completely normal 8 days after surgery. In fact, I consider these changes to be normal for several weeks.

The decision to have a facelift is a big one...and the first thing patients do when the bandage comes off is to feel concern about imperfections. You are not alone! 

All of the alternatives you mentioned--re-incising the scar, laser therapy etc--are things you can consider many months after the first surgery. The scars behind your ears will continue to be bothersome for a little while; that is normal. 

Likely you are scheduled for a two week follow-up with your surgeon, and they will reassure you further. Nothing you have mentioned warrants earlier than usual follow-up.

Bay Area Plastic Surgeon
4.8 out of 5 stars 18 reviews

Visible Scars after Surgery

What you are describing sounds pretty normal 8 days after surgery.  However, you should consult with your surgeon or his/her clinical team and let them know of your concerns.

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 120 reviews

Scars After Neck And Jowl Lift

Dear PreciousOne53,

Being only eight days postop after neck and jowl lift, it is relatively normal to have a small degree of puckering. It is not normal to have a lot of puckering. It is possible to revise the incisions and skin flaps to allow more even distribution of the skin to cause less puckering, however, it would be wise to wait at least three months to see how everything matures prior to even thinking about this.

Warwick Nettle, MBBS, FRACS
Sydney Plastic Surgeon
4.8 out of 5 stars 91 reviews

Puckering of facelift scar

without photos or examination, it is difficult to judge whether you are experiencing normal stages of healing or have a condition which requires intervention. 
In these early stages of healing after face lift and neck lift surgery it is best to ensure close follow up with your surgeon. He will be in

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 49 reviews

Incisional puckering after facelift

Dear Precious,
Thanks for your question. You are probably at the hardest part of your recovery becaused at one week you are ready to be over your surgery but your face is lagging behind. The puckering you see is related to the swelling and the suturing but it will smooth out in time. The incisions in front of your years generally heal very well but do not expect them to be inconspicuous for another 3-4 months. The same goes for the heavy incisions behind your ears. Some light massage may speed the process along and in our practice we have had great results with SkinMedica's Scar Recovery Gel. Be sure to follow-up with your surgeon and take his/her advice regarding scar massage and ointments, gels, etc.  Be patient and you'll be rewarded with a great result. Best wishes.

Kevin L. Smith, MD, FACS
Charlotte Plastic Surgeon
5.0 out of 5 stars 42 reviews

Massaging incision

Hello, yes it's normal. You are only 8 days post op and the incision is still healing. It is too early for laser therapy. I would recommend that you massage and even put a warm (not hot) compress on the incision daily. Best of luck. 

Michael E. Jones, MD
New York Facial Plastic Surgeon
3.5 out of 5 stars 18 reviews

Neck lift 8 days postop

At 8 days postop, you are healing still. While not every patient experiences puckering, it is not unheard of. Give yourself time to heal and discuss this issue with your surgeon at your next postop visit.

Suzanne Kim Doud Galli, MD, PhD, FACS
Washington Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

Is this normal?

At 8 days, you are still very early in the healing process. Without picture it is hard to know what is going on. Keep in mind that you are still swollen and your incision won't even begin to flatten and fade until 2 months. Give your body time to heal and keep any scheduled follow up with your surgeon for his advice and evaluation. Good luck, Dean Vistnes.

M. Dean Vistnes, MD
Bay Area Plastic Surgeon
5.0 out of 5 stars 48 reviews

I have some very visible scar puckering after neck and jowl lift. Is this normal?

Without seeing you in person or photographs, it is hard to make an accurate assessment of what's going on.  Lumps and bumps under the skin are normal in the post-op period following facelift -- this often resolves with time.  Additionally, incisions may appear puckered for some time in the initial healing process.  I warn patients to expect numbness, lumps and bumps and pink firm incision lines for a good while after a face lift. It subsides quicker in some people than in others, but it is normal and expected. 

Raised and thickened scars behind the ears are typically a result of stressing those areas -- usually by turning the head too much in the initial healing period.  I advise all patients to avoid such strain for about 2 weeks post-op.  In patients exhibiting raised/ thickened scars, I will sometimes inject the scars with steroids (even early in the healing period) and advise the patient to massage them gently.  

As a rule, following any facial surgery (or even trauma), 80% of swelling is generally gone by 2 weeks and 90% of swelling is generally gone by 2 months. The remaining 10% of your swelling gradually resolves over the remaining 10 months, which is why many doctors will tell you that it takes up to one year for post-operative swelling to resolve.

You must not evaluate the results of your surgery too soon!  Give your face and scars time to heal before considering revision work. I wish you well!

Parker A. Velargo, MD
New Orleans Facial Plastic Surgeon
5.0 out of 5 stars 49 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.