What should I do about complications from a Mid face/Neck lift, 4 1/2 weeks post-op? (photos)

I had a bleed when drains were removed. Not drained or cleaned out. Lumps & cords are now showing up. Area under chin is a thick, firm pad. When I look at down at my desk, for example, it presses on throat, feel like I’m about to be choked. Could this worsen? Had 1 visit with a physical therapist, “<40% movement side-to-side. Raising my head up from position shown 0%. This effect my ability to work, to drive, etc. Not sure if I can wait 6-12mos. for this to heal & what type of Dr. to see.

Doctor Answers 7

Neck swelling after facelift

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You have significant swelling of the upper neck still.  It appears as though there may be some scar tissue at the neck crease impeding the drainage of the edema.  You also have some irregular areas underneath this.  I would recommend some massage over the swelling to start to get the edema draining and to start softening the area.  This is going to be a slow process.  Warm compresses may help.  It is hard to tell if all of this is going to smooth out for you.  Some ibuprofen may also help as an anti-inflammatory.   

Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 31 reviews

A hematoma after a face lift can cause thick internal scar

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Thank you for your question about your face lift.

I am so sorry you had a complication from your face lift.
I can see how troubling it can be -
  • You have a lot of internal swelling - it should get better, not worse with time.
  • Internal scars improve but it is hard to hurry the process
  • Massage, compression bandages, ultrasound and steroid injections may, or may not, help.
  • If you have lost faith in your surgeon, get a second opinion from another plastic surgeon.

Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.

Lumpiness after failure to evacuate the hematoma after a facelift will lead to a prolonged convalescence.

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In general it is best to remove a hematoma as a complication of a facelift as soon as it is recognized. This will decrease the bruising and swelling. Most of the time the final result will be unaffected but significant scarring might require a revision. At the moment it's too early to tell.

Relieving Your Complications May Take Time

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I'm sorry to read about your concerns. From the photos, it appears that you have prolonged swelling and there may have been a collection of blood underneath the skin. If there was a collection and it was not drained as you suggest, it will take time for the body to resorb it. There will be scar tissue that will form as this process continues, and it will take time to soften. Lymphatic drainage techniques and ultrasound can be used in order to help quicken the process, but it will take time and patience is necessary. Continue to get the help of a physical therapist or other medical specialists, and best wishes in your recovery.

This looks like fibrosis after a facelift hematoma

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Without looking at and touching your neck it is not possible for me to give you an exact answer. If you did have a hematoma following a facelift it is very common to see some fibrosis and contraction in the area where the hematoma occurred. This is why we like to drain them as much as possible to reduce the fibrosis that develops. When the involved area is small it will usually get better with massage and stretching exercises. In large cases re-operation is occasionally needed. Talk to your surgeon. If you are not getting answers get a second opinion. Hope this helps.

Ivan Wayne, MD
Oklahoma City Facial Plastic Surgeon
5.0 out of 5 stars 65 reviews

Massage, warm compresses, lymphatic drainage

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The problem that you're having is related to the postoperative bleed. At this point your best bet is to apply warm compresses massage the area And going to facial aesthetician that can perform a lymphatic drain massage and sometimes local injections of Kenalog can help with resolving the scar tissue. Eventually it is going to improve significantly and in several months it will resolve completely but unfortunately you need to be patient.

Vartan Mardirossian, MD
Jupiter Facial Plastic Surgeon
4.8 out of 5 stars 50 reviews

Swelling after Facelift

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Dear larkar thank you for your question.Swelling after a facelift may persists from weeks to months, causing bumps or asymmetries to appear. In San Diego, we monitor our patients closely for one year to address any issues. Follow up with your surgeon to check if this is swelling versus something else and if treatment is indicated. Best of Luck.

Roy A. David, MD
San Diego Facial Plastic Surgeon

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.