I had Lower Face Lift 3 wks ago, swelling under my chin hasn't subsided, I had an ultrasound which ruled out hematoma. (photos)

Question

My Ps wants me to return back abroad to aspirated. Can this be done by a general surgeon in the uk how do they aspirated? is it with a needle or drain do other doctors feel aspiration is needed.my neck looks worse than before at the moment

Timothy R. Miller, MD · Answer

I'm sorry you are having these issues.Assessing your "before" pictures would be helpful in determining the cause of the fullness after your lower facelift. However, it is more than likely you have a seroma in the area.  I would strongly recommend seeing a plastic surgeon, general surgeon, or if possible the surgeon who performed the procedure, and an aspiration (with a needle) would more than likely help remove the fluid.  Delaying treatment could cause the fluid collection to harden and calcify, leading to aesthetic issues or it could become infected.I hope this helps.

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Hi CattzIf you only had facelift surgery - this is likely to just be soft tissue swelling that is very rare but can happen and as this is the most dependent part with gravity the swelling from this area will take a while to settle.However if you had neck tightening or neck lift procedure at the same time as your facelift then it is important to rule out hematoma which you have done, which is good. In some patients they can develop a yellow fluid called a seroma which can be aspirated. This is simply done under local with a needle and may need to be repeated a number of times over the weeks while your body starts to absorb the remaining fluid and not produce any more.I would recommend that you see a plastic surgeon here that is familiar with aspirating this rather than a general surgeon and in some cases, they may recommend that you wear a pressure garment to minimise more fluid collecting in the area.All the best with your outcome.

Larry S. Nichter, MD, MS, FACS · Answer

Without an exam it is impossible to make a diagnosis or give advice other than see a plastic surgeon (preferably your own surgeon) with expericence in facelifting.

Robert M. Freund, MD · Answer

A seroma is a straw colored fluid that accumulates in a surgical space like a neck lift. The fluid may absorb slowly but aspiration or drainage can allow it to heal much faster. In my experience many seromas need to be drained multiple times and the more frequently it is drained, the faster it will resolve.Seek out a plastic surgeon in your neck of the woods and it will certainly be taken care of properly.

Steven M. Daines, MD, FACS · Answer

A plastic surgeon should not need to order an ultrasound to see if there is blood or fluid in a persistent area of swelling after a facelift. Instead, needle aspiration is both diagnostic and therapeutic. The skin is cleansed with an antiseptic and, after a small injection of local anesthetic, a needle attached to a syringe is introduced into the area of concern. The stopper on the syringe is pulled back and any blood or fluid in the area will be drawn into the syringe. After aspiration, a pressure dressing is typically applied for a day or two.Although it is always preferred to have your original surgeon continue to treat you in the post-operative period, a general surgeon in your area should have the know-how to aspirate under your chin.

Robert E. Zaworski, MD (retired) · Answer

If you can not get back to your Plastic Surgeon, see one in your area.  You are a good example of why you should stay close to your surgeon for post op follow ups.  Best wishes!

Brooke R. Seckel, MD, FACS (retired) · Answer

If your ultrasound that ruled out a hematoma or fluid collection (seroma) then you may simply have inadequate correction of the loose skin or residual fat beneath the chin.I strongly suggest you consult a board certified plastic surgeon and the UK.

John M. Griffin, MD (retired) · Answer

I would try to aspirate this area of swelling if I felt some fluid underneath the skin.  Consult a board certified plastic or general surgeon near you.  The procedure is a simple office procedure involving  a needle stick and a syringe under sterile circumstances followed by a small elastic dressing. Be sure to consult a surgeon with a proper amount of experience and qualifications

I had Lower Face Lift 3 wks ago, swelling under my chin hasn't subsided, I had an ultrasound which ruled out hematoma. (photos)

Answers (8)

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