Lumpy Neck, Visible Swelling in Cheeks After Facelift- Is It Permanent?

It's been 4.5 weeks since my facelift. My neck is lumpy and a rather large scar is visiable. If people look staright at me, they cannot see since it's under the chin but if I turn my head they can see it. My lower left cheek has a VISIBLE walnut size swelling. And my left cheek has a once-inch veritical visible "thingy" (looks like a smooth rope under the skin). I'm seeing my plastic surgeon in a few days but will these go away or I am stuck with them forever?????

Doctor Answers 19

Swelling after facelift

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Thank you for your question for sharing your concerns with us. Swelling and lumpiness in the tissues will return to normal as time passes by. Between the first and second week, much of your swelling and bruising will dissipate. It may take more than a month or two for your tissues to fully soften and any residual swelling to resolve. Lymphatic massage maybe an option to help clear the swelling and firmness at a faster pace. Numbness may take months to resolve and may never return to the same degree. I would make sure that you continue to follow up with your plastic surgeon during this period of time.

Lumps and swelling 5 weeks after facelift.

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As my colleagues have answered, 4 1/2 weeks to 5 weeks after surgery is still fairly early in the overall healing process, which will take 6 months or longer to reach its full completion and your "final" result. (I put final in quotes because, of course, you will still be aging and no result is truly "final").

Your walnut-sized swelling could be a collection of blood or serum that has (mostly) reabsorbed, leaving a lump of subcutaneous scar fibrosis. This usually softens and diminishes, but may not completely go away. Massage, infrared and ultrasound treatment, and perhaps steroid injections can help this. In the unlikely event this is still a fluid collection, aspiration is possible. Your surgeon should be able to help identify this.

Depending on its location, sometimes swelling just below the jawline can be a protruding submaxillary gland, but you described your swelling as on your cheek, not below it.

The "smooth rope under the skin" you describe may be an internal plication (folding or tightening) suture that many plastic surgeons use to improve the appearance and longevity of results with our facelift patients. Sometimes these tightening sutures below the skin can be visible, but this also usually diminishes as swelling resolves, and the suture dissolves, stretches, or loosens (but this depends on the type of suture used--I use Goretex because it is inherently "stretchy" and has porosity that allows tissue ingrowth, yet is still permanent and does not dissolve). Your surgeon can address this concern as well. BTW, this is one of the concerns with "threadlifting" since the barbed sutures must engage with the skin to "pull" it tighter. If too superficial, the barbs can be felt, seen as a "rope" or tether, and then the barbs break off or bend back and the "lift is lost. Most reputable plastic surgeons do not perform or have abandoned threadlifting for facial rejuvenation.

Your scars are permanent, so at this point you have to trust that your surgeon used discretion in choosing incision placement, and fine technique in closure, so that over time the scars will soften and fade to near-invisibility. Avoiding ultraviolet (sun or tanning bed) for up to a year after surgery is critical to prevent hyperpigmentation (dark brown discoloration) of your scars.

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Swelling after facelift surgery

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Face and neck swelling and tightness one week post operative lower facelift surgery is normal. Swelling and numbness after any facelift surgery is expected and normal. Usually, most of the noticeable swelling is reduced within a couple of weeks, perhaps in some cases a couple of months. Initial icing will help to reduce swelling faster. Good luck and good healing

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 224 reviews

Healing after a facelift

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Generally speaking, it can take 6 to 12 months to completely heal after surgery. Please keep in touch with your surgeon or his/her clinical team to discuss your ongoing concerns.

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 124 reviews

Lumpy Neck and Cheek 4 Weeks after Facelift

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    All of these bumps may be normal swelling, but they should be evaluated for fluid collections or hematomas as well as fat necrosis and suture reactivity or tissue bunching.  Kenneth Hughes, MD Los Angeles, CA

Lumpy Neck, Visible Swelling in Cheeks After Facelift- Is It Permanent

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It sounds like there was a large amount of swelling and possibly bleeding during your procedure. That can cause what you are seeing and in time should get better. There might be some shots like kenalog that might help in some cases too.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

4.5 Weeks After a Facelift

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It is far, far too early to make a judgment on your final result.  You can expect some degree of incisional redness, in addition to areas of swelling which are most likely related to lymphatic edema.  Gentle finger tip massage, and more importantly.... time are likely to help.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 103 reviews

Swelling After Facelift

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  One month after facelift surgery seems like a long time.  However, it is not until six to twelve months after surgery before all of the swelling is gone and the scars have matured in appearance. 

  It is common to have concerns similar to yours after this type of surgery.  With time and massage, many of the firm areas soften and incisional scars fade away.  I would not become preoccupied with thoughts of a revision only a month after surgery. 

  I do agree that visiting with your surgeon and communicating your concerns are a very appropriate and important steps.  Your surgeon has specific knowledge of your procedure and should be able to guide you to the right postoperative strategy to manage your concerns.       

Hope this helps.

Christopher Kolstad, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 59 reviews

4.5 weeks post-op

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Each situation is unique and only your surgeon knows the specific details of your procedure and should be the person commenting on post-operative questions such as this

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Early face lift results.

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Rarely patients develop a small collection of blood that forms a clot. One has to wait for that to become liquid so that it can be aspirated. The walnut size lump could be one of these collections which could be aspirated with a needle in the office. See if your surgeon can help you with that. If the blood clot is not aspirated it will turn into scar tissue but with time and massage it should go away.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.