21 months post neck lift - should I have the permanent sutures removed?

Question

I had a necklift performed by a Board Certified Plastic Surgeon 21 months ago. Since day one I have had extreme burning pain just below the ears. My PS said he put permanent sutures in the area of the Lore's Fascia. I have tiny hard bumps in the immediate area which I suspect are granulomas. Could I be reacting to the sutures after all this time or is it the granulomas causing the burning? Should I have sutures removed. My PS dismissed me as a patient after only one visit for no reason and no anwers. I can't live like this.

Tanveer Janjua, MD · Answer

You should try getting steroid injection just below the ear to see if it helps pain. If not then have a surgeon open up the most tender area to see if there is a permanent suture in this area. Once that is pulled out or cut as much as possible it might give you relief. 
Regards
Dr. Janjua

Michael A. Fallucco, MD, FACS · Answer

Thank you for reaching out, and I’m truly sorry to hear that you’ve been experiencing ongoing pain and discomfort since your procedure. That is understandably distressing.

While I was not involved in your surgery and cannot offer a definitive diagnosis without a full evaluation, I can share some general information that may be helpful. Persistent burning pain and palpable nodules in the area you described could potentially be related to a foreign body reaction, including suture-related granulomas. Permanent sutures placed near the Lore’s fascia can sometimes cause irritation or even neuralgia if they are close to sensory nerves or if a reaction to the material occurs.

It is possible that what you're feeling are granulomas, and in some cases, these can cause or contribute to pain. Alternatively, irritation of a sensory nerve in the region (such as the great auricular nerve) might also explain the burning sensation. Both scenarios deserve further evaluation.

Given that you're continuing to experience symptoms 21 months post-op and haven't received a clear explanation or follow-up from your original surgeon, I would strongly encourage you to seek an in-person consultation with another board-certified plastic surgeon, ideally someone with experience in revision neck surgery or post-surgical nerve issues. A thorough physical exam and possibly imaging (e.g., ultrasound) might help determine whether the sutures are contributing and whether removal or other treatment is indicated.

You should not have to live in chronic discomfort. Please don’t give up on seeking care, there are options, and you deserve a proper evaluation and treatment plan.

David Hansen, MD · Answer

A few little Kenalog shots into any scar tissue or suture granuloma or areas of pain/swelling post facelift really changes everything for the better. Your derm surgeon can give those shots easily and painlessly.  You don't need to get the sutures removed, --- just get the areas injected and you will be so happy.

Carey Nease, MD · Answer

Hello in Denver! I am sorry to hear that you are having pain after your procedure. If the sutures are truly permanent, which I do not use, then they could be causing the pain and they can be removed. If they are close to your earlobes then it could likely be done in a minor procedure room in an office with local anesthesia. Hope that helps and you find a surgeon in your area willing to help you!

21 months post neck lift - should I have the permanent sutures removed?

Answers (4)

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