Should I be concerned about hardness after my facelift?

Question

I am concerned about the "ropey" feeling on the side of my neck, and hard ridges on the sides of my face, and the severe hardness, not sure if it's just swelling as I had my facelift surgery 12 days ago. If it's swelling, I will just give it more time as this seems to be a slow process. My expectations were so much different from the reality, and I am of course worried, which doesn't help.

Scott C. Sattler, MD, FACS · Answer

The firmness and tissue ridging that you describe is common after face and neck lift procedures. It will take several months for the tissues to return to a normal, soft and pliable state. Massage along the regions of concern is effective, as is external ultrasound therapy.

Kenneth Hughes, MD · Answer

Hardness as well as lumps are normal at 12 days following a face and neck lift. The hardness may take 3 to 6 months to soften, but most of the swelling is gone by 2 to 6 weeks, depending upon what was done and how it was done.

Paul S. Nassif, MD · Answer

12 days is still very soon after your surgery, and you will be experiencing swelling and tightness at this time. It can take some time before the side effects resolve, and it is important to be patient during the healing process. In the meantime, I would recommend speaking with your surgeon regarding any concerns, and seeing him or her for a follow-up if necessary. Thank you, and best of luck with the remainder of your recovery.

Sam Speron, MD, FACS · Answer

Thank you for your question.
	
	To clarify, I am a board certified plastic surgeon who specializes in cosmetic procedures, including all newer aspects of the short scar procedures.  I'm also a proud member of both the American Society of Plastic Surgeons (ASPS) and the American Society of Aesthetic Plastic Surgeons (ASAPS).  I am board certified with the American Board of Plastic Surgery. I am also an active member of the American College of Surgeons.
	
	After many patients receive this type of procedure, they begin to have their doubts and concerns when the healing process begins. Following the procedure, you will feel swelling, stiffness and numbness. The hard areas on the face will eventually fade away within time by applying ice packs and massaging the area thoroughly. A few weeks after your procedure you will begin feeling yourself again.
	
	If you have any further questions, please feel free to call us at 847.696. We would also be happy to mail you some additional information and brochures. In case you have not done so yet, please check out our website at prplastic.com for a wealth of additional information as well as a lot of before and after pictures.
	
	Thanks for your question. Have a great day!
	
	Best regards,
	
	Dr. Speron

David W. Kim, MD · Answer

Given that it is still quite early in your recovery, I would not worry. Contour irregularities (lumps, bumps, ridges, depressions) are pretty common after facelifts and may persist for a couple months. They will likely diminsh steadily and eventually go away. In our practice we combine home massage and in office ultra-sound to help speed the process along. Best of luck!

Peter Lee, MD, FACS · Answer

At two weeks post-op, it is not unusual for patients to note the "ropey feeling" and areas of firmness you have observed in your face and neck. While most of these findings can be attributed to post-operative swelling and inflammation, their etiology may also be a function of the type of facelift your surgeon performed.

	 

	For instance, if your surgeon performed an extended biplanar SMAS facelift with an aggressive plication of the platysma to accentuate the contour and improve the definition of the neck, as I routinely do, you may actually be palpating the overlap of the SMAS flaps in the neck. Similarly, if he performed a MACS style face lift, you may be feeling the elevated soft tissue engaged by the loops of suture he has placed.

	 

	Lastly, although it is uncommon, areas of firmness may denote a small collection of blood or organized clot beneath the skin. The bottom line is that your surgeon is the best person to answer your questions about the specific procedure he performed, and he will probably be grateful for the opportunity to provide you with reassurance that your post-operative course is progressing just fine.

Houtan Chaboki, MD · Answer

12 days after facelift surgery is still very early in the healing process. It's expected to have a degree of firmness or hardness after cosmetic surgery. Most of this sensation is usually due to swelling. Keeping the head elevated, ice packs, salt restriction, and following your plastic surgeon's care instructions will help maximize healing and minimize swelling. Facial massage may help too soften the skin. However, you must speak with him/her regarding any issues you have. Best of luck.

	 

	Dr. Chaboki

Shim Ching, MD · Answer

Swelling can feel like the things you are experiencing.  Facelifts always take some time to recover from.  I think your expectations will be met after your recovery period is over.

Jonathan Kulbersh, MD · Answer

While all of the previous answers are true, there are instances when hardness or ropeyness will need to be treated.  If the hardness is secondary to a collection of fluid underneath the skin, the hardness may be secondary to the skin not proper adhering to the skin.  After removing the excess fluid, this can be an area of increase inflammation.  In these instances, I may choose to inject to the area with 5-fluorouracil to help the area heal.  

	 

	I hope this helps

Earl Stephenson, Jr., MD, DDS, MBA · Answer

This can be normal after facelift.  These areas require patience and massage before resolution will occur.  You are just 12 days into your recovery.  Time heals all wounds.

	Dr. ES