Why Won't Brow Lift Incision Completely Heal?

Question

The incision goes from temple to temple along the hairline. One side at the temple oozes a slight amt of serosanguinous fluid daily. Some area of the incision will itch and then a small amt of yellowish fluid can be easily expressed every day or so.

	There is no pain, redness, heat, or fever. The surgeon says the yellowish fluid is dissolved fat. The incision is pink. When can I expect the whole thing to completely heal? I use Mederma 3x daily on it. What else should I do? Hope the pics went.

Toby Mayer, MD · Answer

I agree with Dr. Blinski. This should improve with this treatment. Any pimples can be opened with a needle and the fluid gently expressed.

Laxmeesh Mike Nayak, MD · Answer

Your particular type of browlift incision - right at the hairline - is intended to grow hair through the incision line. As the hairs grow out, they can often become "ingrown" and cause the symptoms you describe. 

	 

	Also, deep, dissolvable sutures often extrude instead of dissolving, resulting in exactly the same symptoms.

	Be patient, let your doctor help you , and you will be fine.

Peter A. Aldea, MD · Answer

Classical surgical thinking states that a wound fails to heal for several reasons. Among them are infection, foreign body, compromised circulation (oxygen supply), poor nutrition, radiation or that the wound is actually a cancer masking as a wound. We can readily toss out cancer and radiation as well as poor nutrition as totally inapplicable in your case. The wound is in a very well perfused part of the body which should not suffer from circulatory issues unless you were a smoker (and even then it may be unlikely here). Finally, the wound does not appear to be infected. 

	In my opinion you have one or more burried dissolving stitches that your body doees not like. As soon as they are dissolved or removed the wound will heal rapidly.

Houtan Chaboki, MD · Answer

Hi psd,

	Thank you for your question. Based on your photographs, you seem still very early after the brow lift procedure and the incision should continue to improve over time. Periodically, in-grown hairs or internal sutures will create pimples or dimples along the incision. Your plastic surgeon may simply remove these in the office with a small needle. Lastly, infection could occur at anytime and should be closely monitored by your specialist.

	I recommend plain petrolatum jelly, as it has been shown to be as effective for wound healing without potential contact allergy or secondary infections as compared to other topical ointments.

	Speak with your plastic surgeon. Only after a comprehensive evaluation can he/she help determine appropriate options for you. Best of luck.

	Dr. Chaboki

Barry L. Eppley, MD, DMD · Answer

What it appears you are experiencing is very typical for many hairline browlifts. You did not tell us how long ago the surgery was done but I suspect it is only 6 to 8 weeks after the procedure if that. The open areas are likely spitting dermal sutures which commonly react this way. Your surgeon can selectively remove them as they get close to the skin surface and 'bubble' up. This is not a healing problem but a common suture reaction issue. The yellowish fluid is common with spitting sutures and is the result of the body's reaction to them. Stop the Mederma as it is not helping and should only be used on a completely healed and closed incision/scar.

Lawrence Bass, MD · Answer

The treatment issues have been well discussed by Drs. Blinski and Mayer. Mederma is not a treatment for open wound but rather to help improve the appearance of a scar once the wound has been healed for several weeks. The most important question is how long ago your procedure was. This will help gauge whether this is normal healing or very slow or something else is going on. Also the method of closing the incision and possible presence of deep sutures may create drainage and openness issues (sutures "spitting") which may play a role. Your surgeon can give you the best guidance on this. Good luck.

Darryl J. Blinski, MD · Answer

Yes we can examin the photos. Appears as a wound healing issue. Stop the Mederma. See your surgeon for his wound care instructions. I recommend Bactroban and hydrogen peroxide, three times a day.

Vincent D. Lepore, MD (retired) · Answer

I agree that you may have some subcuticular sutures that are getting irritated or have not dissolved yet. If you see any sutures protruding from the incision let you surgeon know and he/she will probably remove them. I would not put Mederma on any area that is open or oozing as this could aggravate the situation or cause an infection. Keep the areas clean with a mild soap and water. You can also use a topical antibiotic ointment such as Polysporin or Neosporin. It looks like its only been a few weeks since your surgery, take heart, things will improve but it may take a few more weeks.

Francis R. Palmer, III, MD (retired) · Answer

The oozing could be from ingrown hairs along the incision line or from subcutaneous sutures used in closure, of the incision, during your Brow Lift. I have always preferred to hide the incision 3 inches into the hairline for these very reasons. You should ask your plastic and cosmetic surgeon during your next post op visit to be sure all is healing well.

Why Won't Brow Lift Incision Completely Heal?

Answers (9)