Still swollen under the jawline 8 weeks after face and neck lift. Is this normal? (Photo)

Question

I am a 60 years old male, 8 weeks ago I had a face & neck lift and double chin removal. I am still swollen under the jawline, my chin it is very 'tight' and 'hard', and a little 'dimply'. My PS told me that this is scar tissue, and that I should massage it twice daily. I have had twice weekly drainage massages for the first 4 weeks, and i am in my forth heat treatment massage under the chin which is every 10 days, Is this normal, and if so how, long before i am completely healed?

Mark Hamilton, MD · Answer

The short answer is yes this can be expected, especially if a lot of work was done.Swelling in the neck after facelift is very common. It may persist for several weeks to months.Massage may be helpful, although there are no published trials showing this. Steroid injections may be beneficial as well, especially if swelling becomes thickened and firm. There are, however, downsides to steroids including skin thinning and broken capillaries. The best thing is time- it does improve and should resolve.

Vincent N. Zubowicz, MD · Answer

The situation implies that you had some thermal treatment to the skin. Is this the case? Laser or ultrasonic treatment generates thermal damage that can create scarring in prolonged healing.

Christopher Khorsandi, MD · Answer

There is always a chance for swelling after a face and neck lift. Massage is recommended along with warm compresses to the area. If this persists you may consider talking to you doctor about getting a dilute steroid injection underneath the neck. Good luck!

John J. Martin, Jr., MD · Answer

Some people will still have swelling in the neck at 8 weeks post-op.  This is especially true for men since the skin is thicker.  Keep up with the massage, and also use some warm compresses.  It should resolve.

Bryson G. Richards, MD · Answer

Thank you for your question and posted photograph.Scar tissue formation will peak at 6-8 weeks. Over the upcoming months, your initial scar tissue will "remodel" and soften. Keep up with the massage. Unless there is actually a pocket of fluid under the skin that needs to be aspirated, it appears that you are doing all the right things. I hope this helps.- Dr. Bryson Richards

Manish H. Shah, MD, FACS · Answer

Hello Carlos54,Thanks for your question.It takes up to 6 months for a facelift to heal enough to feel normal.  At 8 weeks it is normal to have a little residual swelling closest to the incision under the chin.You seem to have a significant amount of swelling though.  There are several possible reasons for this:1.  It is possible that you had a hematoma under your chin and it is now organizing into the scar that your PS speaks of - this will require revision facelift surgery to correct properly. 2.  If you are still wearing night time compression you could be preventing drainage of swelling from the chin causing a backup of fluid - sleeping with your head elevated might help.3.  You may have medical problems that make it hard for you to mobilize extra fluid - sometimes a diuretic medication can help reduce your excess fluid.4.  You may have aspects of your diet that make your swelling worsen: salty diet, excess alcohol, low protein diet - I recommend for my patients to use daily protein shakes in addition to massage for the swelling.I would follow up with your plastic surgeon closely.  After 6 months, if you still have this amount of swelling, I would recommend speaking to your surgeon about possible revision surgery.Until then, be patient as you have some time before you are completely healed.Good luck,Dr. Shah

David Gilpin, MD · Answer

Thank you for your question. At this point, you may still have some swelling under the chin and in the face.  I would still give yourself some time to allow this to subside.  It is difficult to tell from your pictures exactly where your swelling is, but I would also recommend discussing your concerns with your surgeon if they do not resolve.  I hope that this helps!-David Gilpin

Jeffrey M. Darrow, MD · Answer

Your photo appears to show swelling of the tissues below your chin.  8 weeks is still early in the healing process and this swelling should gradually subside over time.  It sounds like your surgeon has you using some modalities which may speed up the resolution so I recommend regular follow ups with your surgeon so your progress can be followed.  Final resolution may take 3-4 months.

Brian Coan, MD, FACS · Answer

Thank you for sharing your question and photos.  Post operative swelling in the face and neck after a facelift and necklift are very common.  It would be helpful to view your before photos to have an idea of your results.  For now, it's still in the early phases and you would do well to continue following up in person with your plastic surgeon.  Very best to you.  -Brian S. Coan, MD, FACS

Gary L. Ross, MBChB, FRCS · Answer

It is still early postop and it is difficult to comment without seeing your preops. You have noticeable swelling and important that your PS is aware and able to advise. It sounds like he/she is advising you appropriately. He/she will know what has been done in the neck and whether this is simple post swelling  / scar tissue. Swelling in the neck does take months to settle and I do encourage massage also. There are lymphatic massage devices available that can help and manual lymphatic drainage techniques which it sounds like you have had. This should settle with time but could take 6 months. Keep in touch with your PS.

Still swollen under the jawline 8 weeks after face and neck lift. Is this normal? (Photo)

Answers (16)

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