Bumps Three Months After Quicklift? (photo)

Hi Maya, 

I perform the Quicklift regularly in my practice. It is basically a concentric triple pursestring SMAS plication facelift. Like all facelifts, some irregularity, nodularity and scar maturation can be expected during the initial post op period (up to 9 months) which will nearly always settle. From your photos it does look like you have an area of "fat bunching" around the plication suture. This will most likely settle with time and massage. If it persists I would advocate serial local steroid injection but not systemic oral steriods. I would not remove the plication suture unless you had an obvious suture reaction. I must say though, this annoying recognised complication aside you do look like you have a very attractive new jawline on profile.

Good luck and thanks for sharing your photos.

Kind regards

Dominic

  It is common to have some lumpiness and bumpiness for 6-12 months after any short incision or long incision lift procedure.  I think it is likely that these will settle, although it is hard to be sure without knowing what suture materials were used.  If the idea of taking systemic steroids scares you, then perhaps you should not take them at this time.  Good luck!

Without an exam and seeing the details of your operative note it is hard to determine the exact nature of these "bumps". However, as they are in the areas where typical suturing is placed it probably represents localized edema or localized fat/soft tissue. Other things could be a small seroma or collection of parotid fluid but which could be determined by aspirating it if your doctor thought there was fluid there.

I do not use systemic steroids in my practice. Occasionally a local injection of steroids and/or 5-FU is helpful along with massage, ultrasound, and other local measures. If you have concerns it might be wise to seek a second opinion from a board certified Plastic or Facial Plastic Surgeon..

Complications of Quicklift -The bumps can be suture related, fat, scar tissue.
If firm, dilute steroid and or 5 fu injections could help.
I would not use systemic meds.
Warm compresses, massage and time, at least 9 mos.

Quicklift is a technique when the sutures are lifting the SMAS.  Some surgeons use addiiotnal sutures besides the one recommended by quicklift to further elevate the tissues in a specific direction.  The bumps may be areas of swelling due to excessive tension.  Most of the time this swelling will resolve with warm compresses and gentle massage.  I am a bit reluctant to recommend 5FU or local steroid.  May be, I would use a small dose of lighter steroid only.  Excessive streroid may soften connective tissue and allow the suture to pull through.  Also, if the sutures uses are absorbable, once the lose strength, the bump will relax on its own.  If the suture is permanent, then you may try to get your doctor either inject it or divide it with a small needle.

Your bumps are likely related to sutures or isolated "islands" of edema. It is likely conservative management with massage and/or steriod injection will resolve the situation in the next 3 months or so.

In reviewing your photos, it looks like your "bumps" are along the areas of the SMAS plication, or where the permanent sutures are lifting the inner support layers of the face;  your surgeon is correct that oral steroids can help, sometimes injecting the inner scar tissue with kenalog steroids can also help, but I would let everything settle for another 3-6 months.

I do not recommend removing the permanent sutures unless you develop nodules where the sutures are tied which can sometimes happen.  Good luck and take care!