Hematoma removed after facelift. Is that a common practice?

I had extreme swelling in one side of my face and I went back and my doctor evacuated the hematoma. Is that a common practice ? It is still much more swollen and harder than the other side of my face. Should I apply warm compresses?

Doctor Answers 24

Hematoma after facelift

Sorry to hear about the hematoma.  Yes, the best course of action once a hematoma is diagnosed is to evacuate it.  You can have residual swelling on that side and you need to have close follow-up to make sure a hematoma is not re-accumulating. 

All the best,

Santa Rosa Plastic Surgeon
4.9 out of 5 stars 30 reviews

Hematoma after facelift

Thank you for your question and I'm sorry to hear that you had a hematoma.  Although not common, it is a risk of any surgical procedure to develop a hematoma.  Your physician did the appropriate maneuver by evacuating the hematoma.  As some of the blood remained in the tissues, this will cause more swelling and bruising than the other side.  Swelling should resolve with time, but the hematoma side will take longer to return to its new baseline.  You may want to try lymphatic massage and follow-up closely with your physician.

Young R. Cho, MD, PhD
Houston Plastic Surgeon
4.8 out of 5 stars 37 reviews

Hematoma after a facelift.

The incidence of a significant hematoma is several percent after a facelift. The proper treatment is evacuation. It will result in more swelling and bruising on the affected side but will not have any influence on the long-term outcome.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Hematoma after facelift

Yes, removal of the hematoma is almost always required after a facelift.  Ignoring one could result in skin loss.

Jeffrey E. Schreiber, MD, FACS
Baltimore Plastic Surgeon
5.0 out of 5 stars 202 reviews

Hematoma after facelift

Hi Thomas, unfortunately, a hematoma is a known risk of facelift surgery. Even the most technically sound procedure can result in a hematoma. In my experience, evacuation of the hematoma is the most effective treatment option. Even after the hematoma is evacuated, you may still have firm, swollen soft tissue that is much more noticeable than the other side. While a hematoma is a frustrating set back, it does not usually have a long term impact and your final result should be great. Regarding management, I would follow up and make sure to be compliant with your surgeon's instructions.

Todd C. Miller, MD
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 34 reviews


Hi.  Sorry to hear about your hematoma.  It's actually one of the more common issues after facelifts, especially in men, people with high blood pressure, and those on blood thinning type medications.  It happens in about 2-4% of people, overall.  Evacuation is the correct treatment.  However, do expect some firmness and some "lumps and bumps" that take a while to resolve.  With time, it should all settle down.

All the best,

Thomas Fiala, MD
Orlando Plastic Surgeon
4.9 out of 5 stars 79 reviews

Hematoma after facelift

Hematomas are not common after a facelift, but they can happen.  They happen in approximately 4-7% cases.  Anyone who states that they have never encountered a hematoma after a facelift has probably not done enough facelifts.  There can be some post evacuation hardness that resolves.  However, please contact your surgeon to re-evaluate to make sure there is not another fluid collection.

Raghu Athre, MD
Houston Facial Plastic Surgeon
4.6 out of 5 stars 89 reviews

Face lift - are hematomas common

Thank you for asking about your face lift.
  • I am so sorry you had a face lift hematoma.
  • A hematoma is a fairly common complication -
  • Evacuation of the hematoma is exactly correct.
  • The hematoma will lead to more swelling and firmness compared to the other side -
  • In time, with healing, it will catch up.
  • As for warm compresses - please get guided by your own plastic surgeon.
  • Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Hematoma known complication

Thank you for your question. A hematoma can be a complication after face lift surgery. The evacuation was the appropriate intervention. Decreasing the chances of an additional hematoma you should follow your physicians instructions regarding activity limitations, avoiding household blood thinners (aspirin, goodies powder, red wine etc).  You can expect that side to have slower healing. At this time focus on allowing time to heal and your physician will direct you when it is appropriate to massage etc to soften the hardness. Most importantly close follow up with your physician is important. Be patient.

Leonik A. Ahumada, MD
Ocala Plastic Surgeon
5.0 out of 5 stars 9 reviews

Recovery takes time

Recovery from hematoma evacuation will take time and could need further needle aspiration.  Keep in contact with your doctor.
Hot compresses are tricky as you facial skin does not have enough feeling to know when it is too hot and you can burn yourself.

Keith Denkler, MD
Marin Plastic Surgeon
5.0 out of 5 stars 18 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.