Hematoma is actually the most common complication after a facelift. It is best treated by aspiration via a needle if small, or open drainage if larger. There will be some bruising, swelling and lumpiness initially, and this usually resolves without issues over time.
A hematoma is not normal but is a complication occasionally seen with the facelift. The proper treatment is recognition and drainage. Properly dealt with it will have no long-term consequences. In the short term there may be increased bruising and swelling in the area.
If you have had a haematoma then it is best to remove it regardless of when it occurs. After removal it is not uncommon for there to be irregularities.
Thank you for your question and for sharing your experience with us. I'm sorry you developed a hematoma after your facelift. Hematomas are usually a result of bleeding in the tissues that is significant enough to cause a visible mass or lump that may or may not need to be drained depending on the size and location. Occasionally, it can be due to a bleed in the artery that may result in a more rapid, expanding hematoma and is usually a cause for more emergent treatment. Spikes in blood pressure, or vasodilation with increased activity can cause a small hole or tear that was previously sealed to open and cause the bleed. This is very uncommon for this to happen, and even less common after 10 days. Swelling after evacuation will persist longer than the unaffected side but should eventually return to a non-swollen baseline. I would follow-up closely with your surgeon who can help monitor the progress alongside with you.
Yes, removal of the hematoma in the office or under anesthesia is usually the treatment of choice for this problem.
This is, unfortunately, a potential complication/risk of facelift surgery. It is imperative to have it dealt with immediately as blood collecting underneath skin - ie a hematoma - can lead to poor healing and the lumpy/bumpiness you describe. Your doctor did the right thing in going back and removing this old blood. Your surgeon should be following you regularly to be sure that you are healing properly. Best wishes.
If a hematoma had developed and was not removed initially, then it begins to turn to liquid and can be removed about 7-10 days after the initial hematoma. This helps speed up the swelling and healing and is routinely done if a hematoma develops.
I hope this helps and good luck.
Various amounts of bleeding occur with any type of surgery. The body can reabsorb small amounts of blood and blood clots, but when there is a hematoma, it is best to remove it. Hematomas normally become liquid on the 10th-14th day. That is when it is the easiest to remove them. From a healing standpoint, it's better that it was removed. If it is allowed to remain, it can harden and take a very long time to heal. It sounds like your surgeon did exactly the recommended treatment of this condition. It may take a little longer to heal than the unaffected side, but it will catch up soon.
John Standefer MD
This is certainly not unheard of. Luckily your surgeon decided to open and remove it. This is the correct treatment for any hematoma of moderate to large size. Leaving a hematoma in his when problems occur. Hematomas are fortunately a rare occurrence, and what is more important is that there handled properly when they do happen. The lumpiness should subside with time. Talk to your surgeon about when in your postoperative course it is safe to begin gentle facial massage.
Best of luck!
Board-Certified Plastic Surgeon
Newtown Square/Philadelphia, PA
A hematoma is a know complication of a facelift with occurs in 1-5% of cases. The proper treatment is to open up and drain it. You may have a bit more swelling and bruising on the affected side, but as time passes things should even out nicely. Sounds like your surgeon managed the problem appropriately. Best wishes on your recovery.