Lower face lift with dehiscence? Treatment opinion requested (Photo)

Question

I had a lower face lift with board certified plastic surgeon. ~ 1 week later I had wound dehiscence and 4 more sutures were placed with continued oozing It is now 1week following the 2nd set of sutures. I notice a deep hole and loss is dermis on the mastoid. I am devastated. It still oozes a bit. Does it sound like a skin graft is in order? What other treatments could be recommended? Thank you

Stephen Prendiville, MD · Answer

A dehiscence of this nature is uncommon, and suggestive that the wound closure was under tension. The best thing to do is allow this area to heal and consider non ablative laser treatments in the future if the scar is objectionable.

Jason Emer, MD · Answer

this is an unfortunate possible side effect of any lifting procedure.  right now wound care is essential.  once its healed, lasers can be used to improve the area or a surgical revision can be performed.  Best, Dr. Emer.

Zoran Potparic, MD · Answer

This is not frequent but unfortunately very unpleasant complication of face lift surgery. Wound in this area heal with scar that may be acceptable or in some cases will require revision. Doing nothing but basic wound care would be my recommendation. If needed, you may consider scar revision when scar is mature. Although this is very dramatic event you should stay patient and follow recommendations of your surgeon. More surgery right now, including skin graft, is not a good option. Patience and good luck.

Brian K. Machida, MD, FACS · Answer

There are various reasons for this to occur but sometimes this occurrence cannotbe readily explained.  It sounds as if your doctor treated this appropriately.  At this point,the area will heal adequately with wound care but will likely take several months.  If theresult is still not satisfactory, scar revision can be considered months later.  I would notconsider skin grafting at this point.

Toby Mayer, MD · Answer

This is not common but can occur. If you have confidence in your surgeon follow his advice about local care and this can be repaired later. Otherwise seek a second opinion from a very experienced facelift surgeon.

Jacob D. Steiger, MD · Answer

Dehiscence after facelift surgery is an uncommon occurrence. Fortunately, these areas usually heal very nicely and in most cases are imperceptible. It looks scary now, but you will be surprised as to how well this heals. Occasionally a small scar revision may be performed if necessary or laser to help reduce redness. Your surgeon should help you get through this.

Lee A. Gibstein, MD · Answer

Thank you for your question and photos. I recently addressed this issue with another patient with a similar problem one month after surgery. While this problem is distressing it is not uncommon and should get better with local wound care and close follow-up These do take time but often heal quite well and require either no treatment long term or minor revision. I think conservative wound care, especially in the early postoperative period, is your best bet. I wound not skin graft the area for this would result in a donor defect and a skin graft never looks quite natural.Try and be patient and hang in there which is never easy but I believe is the best plan.Best of LuckDrG

William Marshall Guy, MD · Answer

Hello Jinaura,What you are having happen is fortunately not common, but can happen with a face lift.  The risk is much higher for those who have nicotine in the blood, so if you are using any nicotine products, it would be very important to stop that until this issue has been resolved.  At this point, placing more sutures would not do much as you have already seen.  Wound care would be the first line treatment.  You will be surprised how local wound care will shrink that area.  It is also behind the ear which tends to be the most favorable for healing.  The purpose of a skin graft is to speed the healing process, but it does require a donor site.  It is not often employed for this type of an issue, but can be used if your surgeon feels it is appropriate.  The drawback is this area is going to heal with a scar.  The good news is, during the healing process other techniques can be employed to further help the healing process and camouflage the area.  Continue to follow up closely with your surgeon.  It is possible down the road that a scar revision will be require.d  I hope this helps and good luck.

Lower face lift with dehiscence? Treatment opinion requested (Photo)

Answers (8)

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