10 Days after Deep Plane Facelift, I have a dark shadow which is progressively getting darker. Should I be worried? (Photo)

Question

today marks day 10 of my mid deep place facelift. Alternate Stitches were taken out day 5 and the remaining removed day 7. Approx 90% of swelling has subsided. Left tissue dermal shaved alot and drapped over tragus to achieve more natural area doc said. Healing well. No swelling nor pain. Face slowly getting sensation/ tingling. Hardness subsiding fairly quickly Im worried about the right side (arrow) dark shadow progressively gets darker. It this a concern? Is it Necrosis? Im scared!

Alexander Donath, MD, FACS · Answer

This doesn't appear to be an impending necrosis but it is difficult to tell for certain from the photos. Typically we would see evidence of that before 10 days. It could be delayed presentation of bruising as well. Follow up with your surgeon and hopefully it will resolve spontaneously.Hope that helps and best wishes, Dr. Donath

Keshav Magge, MD · Answer

Thank you for your question.  This likely looks like bruising/ heme that is coalescing and changing colors under the skin.  Not an uncommon issue.  Best to speak to your surgeon though about your concerns. All the best

Jeffrey H. Spiegel, MD · Answer

It looks like you have the usual swelling and bruising of surgery. Overall that looks pretty good and the redness, darkness is less than many people get.  So far so good!

Brian M. Harmych, MD, FACS · Answer

Thank you for sharing your photos and questions.  Based on the view provided from your photos, it appears that you are healing nicely.  You likely had a small amount of superficial skin sloughing over the tragus that has resolved nicely.  I don't see any evidence of impending superficial skin necrosis currently. Continue to observe strictly the activity limitations and postoperative care provided by your surgeon so you can be sure you do your part to ensure the best result possible.

Frank P. Fechner, MD · Answer

After reviewing your photograph I feel that you are healing appropriately without signs of skin necrosis. Your incisions are coming along well. Stay in close touch with your surgeon; he did a fine job.

Catherine Winslow, MD · Answer

Hello! Your tragal skin does look dusky and possibly crusted. You should discuss this with your surgeon. Even if it IS necrotic, it is likely to heal without intervention into an acceptable scar due to the location but again, discuss with your surgeon. Good luck!

Andrew Campbell, MD · Answer

The dark area you show in your photos is most likely nothing to worry about. You are already 10 days out from surgery, so it would be highly unlikely to be necrosis. More than likely, it is just a deep bruise that is finally making it's way up to the surface and is becoming visible. The good news is that your body has been trying to get rid of the bruise for the past 10 days, so it won't last long. The darkness will most likely fade over the next week or so.Good Luck,Andrew Campbell, M.D.Facial Plastic SpecialistQuintessa Aesthetic Center

Evan Ransom, MD, FACS · Answer

Thank you for the question and your photo. It does not seem, from the photo, that this is an area of necrosis (dead skin). It may be a bruise, or a subtle contour abnormality that can occur with the deep plane technique. In this type of facelift, the only area of the face where the deeper connective tissue and muscle layer is separated from the skin is directly in front of the ears. Therefore, blood can collect here initially after surgery, and there can be different amounts of swelling in front of and behind the transition point. In the overwhelming majority of patients, these issues resolve as the healing continues. Best of luck going forward!

Miguel Delgado, MD · Answer

Overall, it looks like you are healing very well. It may be a small collection of blood which will resolve on its own.  Sometimes if it soften your PS may aspirate the area. Good luck.

Akshay Sanan, MD, FACS · Answer

Dear katsee,
Thank you for your question and photos. After reviewing your photos, you are healing as expected for 10 days after surgery. Your tragus will heal fine with time. There is no evidence of necrosis on the right side. I would caution you to be careful what you read online about facelift complications. I would be in touch with your surgeon. Your surgeon did an excellent job. I hope this helps answer your question.
All the best,Dr. Sanan, MDAkshay Sanan MD Facial Plastic SurgeryDouble Board CertifiedStanford University Trained

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