I have a ridge/line near jaw after MACS facelift. Any suggestions? (photo)

My skin looks like it's pulled to much on one side creating a ridge /line with loose skin under it I'm only 4 days post op so hoping it's just swelling but it just doesn't feel right. Any suggestions as to what it could be would be gratefully received.

Doctor Answers 14

Ridging 4 days after MACS lift

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This is the effect of the MACS tension sutures on which the operation is based.
I found that the suture pull lines very problematic, required correction and I stopped doing this procedure.

Let the swelling subside. Point out the problem to your surgeon and have the suture cut or corrected in 2 weeks if the pull line does not subside.  

Skin Contour Irregularities Will Smooth Out

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I wouldn't be too worried about it just now (although I appreciate that you are).  These types of issues come up from time to time especially with facial surgery, but it typically shakes out within a few weeks.  Hang in there.

I have a ridge/line near jaw after MACS facelift. Any suggestions?

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Patience!  It has only been 4 days!  

It is very common to have contour irregularities immediately after facial surgery.  These depressions will lessen with time and will likely be gone soon.

Good luck!

Some Contour Irregularity Immediately After Facelift is Normal

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Plastic surgeons know that patients want to look great immediately.  This has led to the development of less invasive procedures.  The MACS lift is one of these.  While faster recovery is nice, the downside is that temporary contour deformities are more likely.  This is such a common issue with the MACS lift that the authors specifically discuss it in their textbook.  Correction is time and massage.  

Joseph Campanelli, MD
Portland Facial Plastic Surgeon

Ridges following Facelift.

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A MACS facelift is one of a continuum of face lifting technique styles which have progressed over the last 50 years. 

There are 3 basic layers of tissues to be "lifted" in the face:
  1. the skin
  2. the SMAS (a fascial corsette underlying the skin which keeps the tissues tight and together)
  3. the soft tissues including muscles, fat, nerves and blood vessels. 
Most facelift techniques use the first 2 layers to perform the lifit.
  1. the skin is most recently redraped in a superolateral (upward and outward) rather than backward direction and the excess is trimmed.
  2. the SMAS is pulled and tightened in a superior (upward) direction and the excess trimmed or doubled over to add more volume.
  3. the soft tissues maybe volumized to fill, soften and change the contours and folds of the face. For example, fat or filler maybe used in the cheeks, temples or nasolabial and marrionette folds. 
During the initial healing process, swelling and pulling of the skin or deeper tissues can cause this wave form you present in your photo (thanks for sharing it with us). Other considerations are redraping the skin or pulling the SMAS in a backward direction. 

My suspicion is that the tissue tightness will relax during the next few weeks as the swelling diminishes. In approximately 3 months with some appropriate massage, you will observe a more natural appearance.

It is best that you return to your surgeon and review with him / her your concerns so he / she may instruct you as to what to do and provide his / her experience in managing this issue. 

I hope this was helpful. I wish you the best!

Contour issue after facelift

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Thank you for the picture.  This may represent a slightly tighter area that has be accentuated by swelling.  You should have a re-evaluation by your plastic surgeon.  This should soften over the next several months.

I have a ridge/line near jaw after MACS facelift. Any suggestion

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ONLY 4 DAYS!!!! At least allow 3 months healing before considering any type of revision. Much to early.....

4 day post-op ridge

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At 4 days post-op it is not uncommon to have irregularities under the skin.  This will be due to uneven swelling. Give yourself time to heal and most of these will resolve.  IT would be unusual to have anything in that area that would cause permanent creasing.     


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What it could be... its likely due to how the skin was repositioned. If to much tension is placed on one area of the skin flap...it will result in a band where the skin is taunt in the direction of pull and looser above and below it, thus creating the line or band appearance. The way to avoid it is to put even distribution of the tension on the skin flap...or to put less tension in that particular area that caused the band. You are still very early and edema can create abnormal forces on the skin. I would not get discouraged this early.... I would wait until the swelling decreases and your skin relaxes which can take a few weeks. 

You need to wait

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The result of facelift will take months to show. Please continue to see your surgeon. There is nothing to offer you at this beside waiting.

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.