Facial Redness After Facelift?

Question

Although the black & blue bruising is gone 2 months post surgery, the sides of my face where it is still hard and tender seem unusually red, and the skin is not smooth at all. Will this disappear with time, or is it something that should be addressed and treated? It's still too tender for any thick make up, can only use powder so it's very obvious. I see doctor in a week, but would like additional opinions please! Thanks so much.

Babak Azizzadeh, MD · Answer

2 months post procedure is still very early in the healing process, and it's extremely common to still experience minor symptoms like redness and tender skin.Over the first six to 12 months, most raised skin irregularities settle. However, it sounds like your concerns may be more than the typical healing process. I suggest you revisit your surgeon to double check everything.

Paul S. Nassif, MD · Answer

It is not abnormal to have some residual redness and irregularities 2 months after your facelift. An exam and/or photos would really be necessary to provide you with recommendations. Speaking with your surgeon at your appointment will be best, as they will be able to provide you with advice. I hope this helps, and I wish you the best of luck with the remainder of your recovery.

Frank P. Fechner, MD · Answer

Although you should look great by now, the skin still will feel firm at this point in your healing progress. Some mild pinkness can occur but it is rare. I would expect this to improve with time. Your cosmetic surgeon may recommend a laser treatment to speed this along.

Vincent N. Zubowicz, MD · Answer

Increased blood supply to the cheeks resulting in redness can persist after a facelift is a normal component of a healing process. This is more likely to be seen in patients with rosacea. The condition should pass with time.

Kenneth Hughes, MD · Answer

Hardness is to some extent unavoidable, for as scars mature they harden first and then soften. This will get better over time. The redness is not likely an infection. Facial infections after facelift occur at about 0.5%. If you had small residual hematomas or slightly compromised skin or both, the redness may take longer to dissipate. As always, this is speculative as there are not pictures and an exam by your surgeon will be the best comfort.

Michael I. Echavez, MD · Answer

At two months after your facelift, there still will be additional healing taking place. Pictures would be very helpful, but I would say that there most likely will still be some improvement over time. If you skin color is fairly light, it would not be unusual to have some redness, but it should be improving over time. Additionally, any firmness or tenderness should also be improving with time. I would make sure you keep your appointment with your surgeon next week, and he or she should be able to evaluate your progress.

Todd C. Miller, MD · Answer

The hardness that you are experiencing is most likely residual swelling. Swelling can take up to a year to completely resolve. During that process the skin and underlying muscle will gradually soften and the contour will even out. If you are still using antibiotic ointment on the incision lines it may be causing the persistent redness. Make sure that you have consistent follow up with your surgeon to ensure that you are healing normally.

Adam David Lowenstein, MD, FACS · Answer

It is not unusual to have some ongoing manifestations of healing as late as 2 months after surgery. Some redness in the skin can be a sign of ongoing normal inflammation and while not common, will likely improve. I do agree with having your physician follow your progress so all of your questions can be answered.

John C. Ferguson, MD · Answer

These symptoms often occur in the areas where the skin is elevated in the subcutaneous planes. If this flap of skin and fat is thin than any irregularities in the underlying tissue is visible. There are almost always minor irregularities here, as this is where the true "lift" of a facelift occurs. These settle out over the first six months. When the skin is elevated it turns into what we call a random pattern flap. That means the blood supply comes from where it is still attached and is distributed through out the flap in the network of tiny vessels that are in the dermis. Sometimes those vessels dilate and become visible. This is especially noticeable in fair skinned individuals. Sensory and autonomic nervous supply to this area is disrupted leading to hypesthesia or hyperesthesia (decreased or increased sensitivity), intermittent flushing, and decreased ability to constrict the blood vessels. As these nerves and vessels heal, these symptoms usually disappear. If the redness is still present after a year it is amenable to light therapy (IPL or laser).

Jeffrey Zwiren, MD · Answer

It is hard to tell exactly what is your specific problem. It is not unusual to have some firmness and redness of the skin following a facelift. There are many different types of facelift procedures and some undermine the skin more extensively than others. The undermined skin frequently turns red for a short period of time. Over the first 3 to 6 months the redness,lumps, irregularities and swelling should subside. It it possible that you had a chemical peel or a laser treatment to your skin at the same time. This may account for some of your redness. Your plastic surgeon is in the best position to tell the extent of the problem and to suggest possible treatment strategies.

Facial Redness After Facelift?

Answers (12)