Swollen and Lumpy 3 Weeks Post-op Facelift/necklift - Is This Normal Healing?

When the skin is separated from the underlying tissues during surgery, small sensory #nerves are cut. Varying degrees of numbness will be present after surgery and will improve gradually as the nerves reconnect to the skin. This process can take from 2-6 months for face, neck and cheeks, and to 9-12 months for the forehead and scalp. Muscle weakness may also be present around the mouth especially if liposuction is used. This typically recovers fully in the months after surgery. As the nerves regenerate, the itching, burning, tingling and shooting #sensations will occur. Ice, moisturizers and gentle #massaging are helpful during this phase of the #healing process. Frequently there is a tight feeling in the neck, jawline and cheek after a facelift. During surgery, not only the skin but the underlying muscles are tightened to create a better and longer lasting result. Additionally, the #swelling will move downward in the first week and the neck will feel even tighter. Do not be alarmed: the sensation will decrease during the first month. Some degree of firmness or lumpiness under the skin is normal after surgery and will resolve with time. Local massage will speed resolution of this problem, which normally takes 2-4 months to disappear completely. If you have certain concerns about the procedures and #healing process, it is recommended to call your board-certified surgeon or their medical staff and discuss those #concerns.

Although in surgery the effort is to control bleeding and subsequent swelling, fluid collection under the skin can still happen.An assessment with your surgeon would be valuable to identify whether  this is a soft  swelling which would more likely represent a seroma  (collection of plasma under the skin) or whether the swelling is firm. When the swelling is soft draining it can help speed up the recovery and reduce the risk of an infection setting up in the area. When the swelling is firm, it is debatable whether intervention is more valuable than waiting. The body has its way of dealing with the swelling and although steroid injections can help they can also produce some problems.

Hi @Jackie43! Thanks for the question and sharing the picture. 
You're healing as-expected for 3 weeks! This is normal at this stage.
Facelifts vary from surgeon to surgeon, but after a true facelift based on modern principles of aging and a proper SMAS flap, you can expect a week of bruising followed by another week of swelling. Adding an extensive neck lift may add a few days to recovery.
Fat injections are powerful adjunct to any facelift, but the downside is that it can prolong the period of normal swelling by a week or two. Especially in the lips, the swelling can last a very long time but the upside is no more paying for filler every few months.
Swelling follows gravity, so the last area to stay a bit firm and swollen is typically the neck but this is barely noticeable and concealed easily with a scarf.  
In Minneapolis we often advise our Facelift Patients to take Arnica and Bromelin which have been shown to reduce the period of bruising and swelling.
Lumpiness can result from the way your body heals in response to the suturing under the skin, but this usually subsides by 3 months. At times it can take up to 6 months. The best would be to keep checking-in with your surgeon regularly and after 6 months you may elect to have filler or microfat injected to smoothen out the area.


If you’re slow to recover with swelling try adhering to a diet rich in fresh fruits and vegetables, avoiding any salt whatsoever. This, combined with a few lymphatic massage treatments can do wonders for reducing facial swelling after a facelift.



K. Chopra, M.D.

Plastic Surgeon

Johns Hopkins Trained

Face, Body and Breast Expert