Facelift/necklift healing sensations - how do surgeons know what's normal if they haven't experienced the surgery themselves?

I am curious to know how, when a patient tries to describe the various sensations during healing, the surgeon can possibly know if these sensations are normal? For example, 6 months after FL/NL & platysmaplasty, I am still having "uncomfortable" pulling sensations in my neck. My surgeon said it was scar tissue contracting, but it doesn't seem to be easing off. It's difficult to describe the sensations, & as the surgeon hasn't had a facelift himself, how does he know everything is OK underneath?

Doctor Answers 22

It Comes With Time and Experience

You raise an interesting point, and you're correct to say that many plastic surgeons have never actually endured the very healing process that they're guiding you through. However, seeing hundreds (or even thousands) of patients recover from a procedure gives a surgeon a lot of experience and insight beyond what he or she might acquire simply from undergoing a procedure. To put it another way: I can be more confident in concluding that a patient’s sensations are "normal" if I learned about similar sensations in my training and have heard my own patients describe similar feelings many times before. In your particular case, I can reassure you that pulling sensations are normal consequences of any surgical procedure, as your doctor said, caused by the scar tissue "contracting" or simply being put under tension during neck movements. The sensation should go away as you continue to heal in the months ahead, but if you continue to be concerned, reach out to your doctor. Best of luck in your recovery!

Toronto Plastic Surgeon
4.8 out of 5 stars 60 reviews

Facelift/necklift healing sensations - how do surgeons know what's normal if they haven't experienced the surgery themselves?

Your point of view is understandable. Many physicians have not experienced a facelift themselves. But, they have performed hundreds if not thousands facelift procedures and their experience is formed by seeing the patients over and over again.

The pulling and hard sensation that you express is normal from any surgery, not only facelift. For quite a while I felt the pulling sensation from my ear surgery and appendix surgery. At about the year mark the pulling or tight sensation went away. So you see, this sensation is not only for lifting procedures, it applies to any type of surgery because the scar tissue tends to create this tight/pulling feeling.

Give it time. This sensation should give at about the 12-18 month mark.

Hope this helps,
Dr. Gus Diaz

Gustavo A. Diaz, MD
Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 15 reviews

A pulling sensation is typical following face and necklift surgery; it is usually not dangerous.

A facial plastic surgeon knows what patients are experiencing and what is normal or not because of the many facelifts that he or she has performed. After performing so many facelifts and listening to so many patients, we have a good idea of what type of sensations patients experience following surgery. We know what to look for in terms of complications and what types of sensations are atypical. A pulling sensation is typical following face and necklift surgery, and while it may be uncomfortable, it is usually not dangerous. I hope this helps.

Facelift recovery

Sensations in the post operative phase can vary.  However, in general tightness, soreness, as well as sharp "lightning bolt" type pains are typical after surgery as the nerves, muscles and tissue are healing.  These should subside with time.

Adam Bryce Weinfeld, MD
Austin Plastic Surgeon
4.9 out of 5 stars 50 reviews

Physician heel thyself

Great question. I have had a facelift and it aint all walk in the park.. Shaving is a bummer when it is numb. There are little electrical twinges when healing. I ve done over 2000 facelifts and I never read about that but some patients describe it..there is so much more

Richard Ellenbogen, MD
Los Angeles Plastic Surgeon
4.8 out of 5 stars 27 reviews

Facelift Healing

How a patient recovers after facelift surgery is known to plastic surgeons because they have seen a lot of patients undergo the procedure. Patients are very expressive about the details of their recovery if asked. But as a general rule in any form of surgery, whatever the surgeon tells you expect that the actual recovery will be about twice as long.

Other patients

in general, the experience physicians have may not be first hand, but the physician will have had many other patients go through the same thing.

Ethan Philpott, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 16 reviews

Facelift - necklift

The pulling sensation is sometimes described by patients, and most of the times it is related to internal scar tissue and part of the healing process. This will usually soften with time, taking up to a year. Discuss your concerns with your plastic surgeon. He is able to give you the right advice, since he/she has performed your surgery and is familiar about the postop course related to it.

Best of luck!

Bianca Knoll, MD
Frankfurt Plastic Surgeon
5.0 out of 5 stars 37 reviews

Post op facelift

Thanks for sharing.  What you are feeling can be normal.  The surgeon's experience is invaluable to patients seeking procedures.  Having performed several thousand face and neck lifts I am in tune with what patients go through even though I have not experienced the procedure myself.  One should choose an experienced surgeon to get the best results and have to have complications handled safely. Follow up with your surgeon and express your concerns and he should take a look and feel to make sure you are healing normally.

Raymond E. Lee, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 71 reviews

Facelift/Necklift Healing Sensations - What's Normal?

Although your surgeon may not have had a facelift himself hopefully he has done many facelifts so through experience has come to understand what to expect in the normal course of healing. You are only 6 months out from your surgery, so it is not completely unusual for you to still have some abnormal sensations in your neck, particularly if you had a platysmaplasty. Depending upon the extent of the surgery and the specific technique that was used, it is quite possible that you are still experiencing some tissue or scar contracture. In fact, after a platysmaplasty, most patients state that they feel tightness and sometimes pulling under their chin. It may take a year or longer for the sensations to return to normal. This does not mean that there is anything wrong going on. If the result looks good and all of your facial muscles are all functioning normally then everything is probably fine. You should continue to follow up with your surgeon every few months until things return to normal.

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.