This is a common area of wound breakdown after facelift surgery. I could be that the skin was pulled under too much tension or that the blood supply to the skin flap just was not robust enough to supply the skin, either way you have a wound and now it is time to help it heal. The good news is with conservative wound care this wound will heal over time unless you have some significant medical comorbitities complicating the situation. Good luck
Post facelift wound breakdown
This is a known complication of facelift surgery. This can occur even if standard surgical techniques were carried out. Post facelift wound breakdown occurs more frequently in revision cases or patients with diabetes or smokers. Wound care and time will allow the wounds to epithelialize and heal. Ultimately a scar revision may be required.
Unfortunately, opening of the incision(s) can sometimes occur with revision procedures. The blood supply can be constricted due to increased tension or the viability of the scar tissue itself. The picture depicted should heal by secondary intention. Close observation and local wound care will be needed.
Poor circulation at the tip of the flap
The wound separation occurs from poor circulation at the ends of the flap from your revision facelift. The wounds will heal and need local wound care as recommended by your surgeon.
Ultimately the scars will be revised to shrink the scars.
This will take some weeks for the wounds to heal.
Best wishes, Dr. Denkler
It is uncommon but not rare for this area to have some delayed wound healing. If you are diabetic or smoke the problems are more common. Right now you need good wound care and cleaning. These will usually heal on there own after several weeks. If they do not heal there are other options such as a skin graft.
Open Wound One Month Postop
Thank you for your question and photos. Wound separation known as dehiscence is not a rare occurrence after facelifting and the most common area is the mastoid which is the location of your problem. There are several potential reasons for this including excessive tension, smoking, infection, hematoma and several others. Good local wound care and close follow-up with your surgeon should facilitate these wounds closing over several weeks. Once closed the area then needs to heal for several months before a determination is made as to whether or not scar revision is necessary. This area if often not very visible, depending on hairstyle, and can often be left to heal without further surgery or simple minor revision
Best of Luck
Is this common?--- No. Does this happen?.....yes. The issue you are experiencing behind the ear is something seen in a small percentage of all patients having certain types of facelifts. When this situation happens the goal is to get the wound to heal up as quickly as possible. There are many ways to treat this type of open wound. It is best to talk with your surgeon and follow their instructions. Wounds in this area heal nicely with local care only. Rarely, a small revision of the scar may be needed at a later date to make it look even better. The area will heal. The key goal is to heal the area as fast as possible so you can enjoy the results.
I have been fortunate not to have that happen
unfortunately it is more common than it should be
with a high smas procedure the actions occurs at a deeper layer so less tension is at the skin level
this makes these types of wound more rare
This appears to be necrosis which occurs when there is too much tension for the particular skin circulation. This can occur even if excessive tension was not applied during the surgery. The best treatment is for a time to let this area heal which may take up to six months. After that time, if there is a problem , scar revision might be done.
Healing problems behind one ear after surgery
Thanks for the question about poor healing behind one ear one month after facial surgery. It is clear that there has been some separation of skin behind one of the ears after a previously performed facial surgical procedure. There does not appear to be an ongoing infection in this area, and I would probably manage this by frequent examinations by your Plastic Surgeon. Good cleaning with the possible application of antibiotic ointment may all be that is needed. Perhaps there may be need of scar revision in the future to this area, but this is yet to be evident. Let your Surgeon direct your wound care for the immediate future.
Good luck to you.
Frank Rieger M.D. Tampa Plastic Surgeon