Puzzling post-facelift complication - can you help? (photo)

I had a facelift in early May. Several weeks later I developed the area shown in the photo, which is over a hard lump beneath the skin. I have been back to my surgeon twice, and he has me on two different types of antibiotics. He says he has never experienced this particular kind of post-surgical complication. Any idea on what's going on? It's almost like a very bad collection of pimples on top of a hard mass.

Doctor Answers 11

Infection Is Likely the Cause

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I'm sorry that you're experiencing this complication following your facelift. I agree with the other specialists who believe this is some form of infection that may be resistant to the prescribed antibiotics. Of course, your surgeon knows your circumstances and medical history best, and you should continue following his treatment plan. Monitor the progress of this closely, though, and don't hesitate to contact your surgeon or another doctor if you begin experiencing physical symptoms, especially fever or soreness. Good luck.

Toronto Plastic Surgeon
4.8 out of 5 stars 71 reviews

Post op swelling and redness in one area after facelift

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You may be experiencing an abscess.  This may be related to a suture or local infection.  I would recommend that you continue to follow up with your surgeon.  Your options may include a small incision to release the accumulated fluids and a course of antibiotics.  The area will will respond more rapidly after this treatment.

Please return to your surgeons ASAP to discuss your face.

Ernest Robinson, MD
Aliso Viejo Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Problem After Facelift

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This certainly looks like an abcess or infection of the facial tissue. It is a potentially very serious problem, and you should consult with your surgeon immediately. Antibiotics and/or drainage may be needed.

Ira D. Papel, MD
Baltimore Facial Plastic Surgeon
4.9 out of 5 stars 36 reviews

Face lift - puzzling complication

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Thank you for asking about your face lift complication.

  • Thank you for the photo. You are right to be concerned. 
  • The first thing you need is a diagnosis. .
  • These will require routine and special cultures for bacteria, mycobacteria and fungi - and a tissue biopsy.
  • You may also benefit from an infectious disease consultation before the cultures are done to be sure that all necessary specimens and tests are collected.
  • The infectious disease specialist may also want you off all antibiotics before any culture - antibiotics can suppress growth of many bacteria so they don't appear on a culture but remain active in your body.
  • If the area is over an internal suture, you may need surgery to remove the sutures -
  • It is rare for sutures to carry infections - but when they do the infection persists until the suture is gone.
  • Your surgeon also needs to alert the surgery center where you had surgery to check their sterilization procedures and report back any problems at once.
Always see a Board Certified Plastic Surgeon.
Best wishes - Elizabeth Morgan MD PHD FACS

Post facelift infection

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This looks like an infection.  When this occurs several weeks after the surgery we worry about a mycobacteria infection.  Special cultures need to be taken and often a biopsy is done.  The culture can then take several weeks to grow and give us the actual bacteria growing.  And then you need to be on antibiotics for several months.  It will eventually get better and will usually look pretty good.  Will want to see an infectious disease specialist for the antibiotics.  

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 31 reviews

Infection After Facelift- Could There Be an Infected Foreign Body?

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It does look like an infection of some kind.  I do think a culture would make sense but my experience has been that often, nothing grows getting culture even though you would think that it would.  The other question is whether there could be a foreign body underneath this area.  I would ask your surgeon if there could possibly be a permanent or a very long lasting suture in this area.  It may be that the suture has gotten infected.  If this is the case, removing the suture, which could be done using a local anesthetic, may cause the infection to resolve quickly. Good luck.

Michael R. Menachof, MD
Greenwood Village Facial Plastic Surgeon
4.4 out of 5 stars 28 reviews

Infection after facelift

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As with any surgical procedure, infection is a potential risk.    

Based on your description and the photo, I think all of us will agree that infection seems most likely.  Obtaining a culture of any infection directly from that area will be extremely helpful if that has not already been done.  

As others have mentioned, a consultation with an infectious disease specialist may also be useful.  Your surgeon has done the right thing with antibiotics, but rarely we see infections with atypical organisms requiring a choice of antibiotics that is not the first choice for the typical bugs.

Best of luck to you.  This is a stressful situation without any doubt, but you are already on the right track with seeking treatment from your own surgeon and the advice of other experts.

David W. Rodwell III, MD
Charleston Facial Plastic Surgeon


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This could be an infection. Some type of culture and drainage could be considered and antibiotics as well. It might be wise to seek consultation with infectuous disease as well.

Brian K. Machida, MD, FACS
Ontario Facial Plastic Surgeon
4.1 out of 5 stars 24 reviews

Post-facelift complication

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If you are treated for an infection, and you are still having problems, it may be worth taking a culture of the fluid to ensure you don not have a resistant bacteria.
Other options would include an infection to the suture used during the procedure, which could be removed, if this is the culprit.

Michel Siegel, MD
Houston Facial Plastic Surgeon
4.6 out of 5 stars 113 reviews

Puzzling post-facelift complication - can you help?

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Hello mkeeshen,

Based on your pictures and description it would appear as if you are experiencing an infection.  If permanent sutures were used in your lift and they have become infected, it can be difficult to get rid of that infection.  If there is any fluid collection or if one area feels softer, I would consider putting a needle in to get a specimen.  I would also consider consulting with an infectious disease specialist for an extended course of antibiotics.  I have not had one of my own facelift patients have something like this, but I have treated a patient from another surgeon who had recurrent staph infections that looked similar to what you have.  It did take a while but with the assistance of an infectious disease doctor we were able to clear her infection without any problems.  

I hope this helps and good luck.  

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 31 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.