Bunching and crease after mini face lift, will it go away? (photo)

Short incision facelift can occasionally create skin folds that are located either under or behind the ear.  In most situations these folds smooth out with time.  Gentle massage and warm compresses can help to speed up the process.  If the folds don't disappear within 6 month a small "touch up" procedure could be considered to smooth them out.  Best wishes! 

Your healing process in general can take up to one month for the majority of swelling to subside, incisions to close, sutures to come out, and for bruising to completely go away. #Recovery time from a #facelift varies from person to person, but patients can generally expect to be presentable within three weeks from surgery. Patients should expect swelling, bruising, and discoloration of the skin during this phase of recovery (swelling normally goes down after 48 hours; most bruising will go away within two weeks). When the skin is separated from the underlying tissues during surgery, small sensory #nerves are cut. Varying degrees of numbness will be present after surgery and will improve gradually as the nerves reconnect to the skin. This process can take from 2-6 months for face, neck and cheeks, and to 9-12 months for the forehead and scalp. Muscle weakness may also be present around the mouth especially if liposuction is used. This typically recovers fully in the months after surgery. 

As the nerves regenerate, the itching, burning, tingling and shooting #sensations will occur. Ice, moisturizers and gentle #massaging are helpful during this phase of the #healing process. Frequently there is a tight feeling in the neck, jawline and cheek after a facelift. During surgery, not only the skin but the underlying muscles are tightened to create a better and longer lasting result. Additionally, the #swelling will move downward in the first week and the neck will feel even tighter. Do not be alarmed: the sensation will decrease during the first month. 

Some degree of firmness or lumpiness under the skin is normal after surgery and will resolve with time. Local #massage of the areas may accelerate the resolution of this problem, which normally takes 2-4 months to disappear completely.The marks from a facelift can easily hidden with “camouflage” make-up which you can learn how to apply. The scars from a facelift mature within six to twelve months from the surgery date. It is during this time that the rejuvenating effects of the facelift will become apparent and the real result will be seen. If you have certain concerns about the procedures and #healing process, it is recommended to call your board-certified surgeon or their medical staff and discuss those #concerns.

It's too early to tell regarding a revision. Usually that kind of pleating will settle down and flatten with time. You will go through a lumpy, bumpy phase from now till about 6 weeks after surgery. Then it will get softer, smoother, and less bumpy. At this point, sometimes massage will help. Also, steroid injections can occasionally be of benefit. It's best to discuss this with your surgeon. Best of luck.

Dear sam, 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.

 Hi, the lump in the lower eyelid may be the result of an internal suspension suture used to perform a lateral canthoplasty.  Bunching around the ears can be related to incision length, the method of skin removal and re-draping.  You should discuss this with and follow the post operative instructions of your surgeon. I have performed many SMAS facelifts for over 30 years and have performed many minimally, invasive SMAS facelifts.  The healing time, signs of skin bunching (if any), lumps and bumps are highly variable and directly related to the degree of invasiveness and how the procedure is performed. 
  The reality is, there are many different ways to perform a facelift from incision length, incision placement, level of tissue dissection (skin only, SMAS, Deep Plane, Subperiosteal), different degrees of tissue undermining, how to lift and support (imbrication versus plication of the SMAS layer), how much excess skin to trim, is excess fat going to be reduced and finally will the overall shape of the face be made more feminine or masculine (while avoiding the over pulled, windswept appearance).  Price is determined by the reputation, location and experience of the Facelift Surgeon and of course by the level of difficulty (for example complicated revision cases).
 In my humble opinion however, there are some basic requirements that must be met in order for a facelift to be "effective", yielding "aesthetic pleasing" and "naturally attractive" results.  These include: 
 1. Some type of incision either curved around the front (preferred) or straight in front of the ear.  This is how excess skin is removed which is not possible with an incision behind the ear alone.  If you have so little excess skin on the face that "none" needs to be removed you are not a candidate for a facelift in the first place.
2. The facelift must address correction and softening of the "jowls" using a long lasting and effective technique.  If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
3. Facial shaping must be combined to properly shape the cheeks, chin, jaw line and lips for feminizing or masculinizing the face as the case may be.
 In my experience, this is the "key" factor in making the face soft, feminine and naturally beautiful.  An essential part of any facelift on a woman.  Conversely, men look chiseled and handsome when angularity is created in the cheeks, chin and mandibular angles.  The ability to provide precise, facial shaping separately or in combination with a facelift is in my humble opinion the definition of a "facial shaping expert".
 If you have "jowls”, in the lower face, these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.

 My most popular SMAS facelift is the minimally invasive, short incision SMAS facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
very small incisions and no incisions extend or are placed within the hair.minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)can be performed in 90 minutes or less, with or without general anesthesiaproper SMAS Imbrication techniqueno incisions within the hair = no hair lossexcess fat can be removed from the face and neckexcess skin removed from the face and neckcheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implantsmost patients fly back home to parts all over the world in as little as 3 days post-op I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.
  Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Should the front portions of the cheeks be flat or concave, cheek augmentation with a dermal filler or using silastic cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.
 When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.  I have found placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.Hope this helps.

Small skin bunching and irregularities may occur after a Mini-lift in the area behind and under the ear.  These folds usually resolve with time.  Massage may be beneficial.If the irregularity is not better after six months a small revision under local anesthesia is possible.Happy New Year! Good luck!

Hi,It's difficult to say how this will flatten out. I would wait 3 to 4 months for it to flatten.Best,Dr.S.