Does this look like necrosis? And what treatment will prevent it worsening? (Photo)

Question

I'm 13 days post op from face/neck lift, and have started to develop areas of what I think is necrosis. Had a lot of swelling immediately post-op, and surgeon stated a lot of bleeding during procedure. Don't smoke I'm concerned more areas will start to break down - left side of face is now looking a little grey Surgeon stated it may just take longer to heal

Fernando Colon, MD · Answer

Thank you for your question as well as photos.  Delayed healing can happen with any type of surgery.  I would recommend following closely with your surgeon to ensure complete healing.  Best wishes!

Sam Speron, MD, FACS · Answer

You need to see your surgeon right away.  While you do not have a large blatant necrosis, you do have evidence of a process that should examined.  Hopefully all is well.

Frank P. Fechner, MD · Answer

Judging from your photos, it appears that you do have some distinct areas of skin slough (necrosis), primarily on the left. Most likely, this will not get worse but improve under close supervision and appropriate management by your surgeon.

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

Thank you for your pictures.  It does look like you have some small areas of superficial skin loss.  Topical antibiotics (Silvadine cream) can be helpful but the areas just have to heal naturally. Revision may or may not be advisable.Dr. ES

John J. Martin, Jr., MD · Answer

It is a small area, and looks fairly superficial so should heal well.  Keep it moist with Vaseline so you don't get contraction of the area.  If you get some scarring - which should be minimal anyway - you can do some laser at about 6-8 weeks to eliminate the scar.  The right side looks more like some residual scabbing. And the darker color is probably deep bruising.

Amy T. Bandy, DO, FACS · Answer

I agree with the previous posts.  You may want to consider hyperbaric oxygen therapy, discuss this option with your surgeon.

Vincent N. Zubowicz, MD · Answer

The skin is definitely suffering after the facelift but it looks from the photograph like it will recover. There may be some intradermal scarring is a consequence.

J. Kevin Duplechain, MD, FACS · Answer

It appears there may be some superficial loss of skin particularly on your left side.  Early intervention with local wound care will likely result in very good healing and an unperceivable scar.  Talk to your surgeon about the best local care and have him guide you.  Fortunately this should heal very well.

Todd C. Miller, MD · Answer

You appear to have some necrosis in front of the left ear. Necrosis can be treated with topical antibiotics and moist dressing. The healing process will be delayed however the area typically heals with little stigma of a scar. Make sure that you are following up with your surgeon and are compliant with wound care instructions.

Roy A. David, MD · Answer

Small scabs may heal without leaving noticable scars. Follow up with your surgeon to ensure proper healing. Good Luck!

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