MACS Facelift Scar Healing Time?

I had a MACS Facelift done exactly a month ago. One side of my face seems to be healing well and the other seems like it may have not been stitched up properly. There are raised bumps and 2 tiny holes in my skin. Should I give it more time to heal or is this something I should worry about? How long does it usually take the scar to heal?

Doctor Answers 40

Early scar from facelift

Scars look the worst one month after surgery, which is where you are now.  Two weeks ago, it wasn't even a scar, just a "wound." This is an early scar--inflamed, red and lumpy.  This is perfectly normal. 

Stiches inside have yet to dissolve completely and may cause lumps as the body is dissolving them. Irregularities and "pleating" are not unusual because there is a difference in actual length on each side of the scar.  All this usually settles down nicely and the redness fades over several weeks or months. 

The tiny openings may be cysts from early hair growth or from pleating and these should resolve, too. It is also quite common for one side to look a little different from the other side. Ask your doctor, but I am sure he or she will let you use make-up. Please be reassured and best of luck to you.

Philadelphia Plastic Surgeon
5.0 out of 5 stars 1 review

This is not exceptional

Dear lady, I am one of the original authors of the MACS-lift technique. The problem you have experienced is not exceptional neither truly worrysome. The smal holes are either caused by hairs attempting to growh through the scar, which is actually the purpose in the MACS-lift sideburn incision, or they are due to a reaction to resorbable stitches which you have reacted to. In the latter case your surgeon will have to pick the small remnants of this stitch out, after which the wounds will close within a week.I

In either case the wound in this location should heal without problem, and end with a very unconspicuous scar. I am curious to know how it healed finally.

Alexis Verpaele, MD
Belgium Plastic Surgeon

Healing after Facelift

Proper healing takes time and is rarely symmetrical: one side almost always heals differently than the other.

What you describe is not unusual, and may be a result of some ingrown hair or extruding sutures.

Your patience will be rewarded.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.5 out of 5 stars 27 reviews

Sideburn scar

Nothing to worry about.  Scar looks hypertrophic but not infected.  What your are seeing are small areas of scabby healing that will resolve.  Now it is important to treat the scars with silicone gel cream, gentle massage.  The scar will definitely improve.  I would not consider a revision this early in the process.

Healing after MACS Lift

This is a great question. First, the body is asymmetric -- so healing may be asymmetric. One side of your face may heal a little faster, have a little less swelling, etc. in the first few months. Generally speaking, these things even out over time. Second, with a hairline incision, as is used in the MACS lift and some other techniques, the hairs have to grow back through the scar. This can result in small cysts or ingrown hairs. Lastly, in any facelift, there is a step where a thin skin flap has to be elevated. Sometimes a very small hole will be created incidentally during this process. These generally heal over time, but may cause some delays in the overall result. Best of luck going forward!

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 84 reviews

Uneven wound after a facelift.

First, you should discuss this with your surgeon.  It probably has nothing to do with the actual MACS sutures. You may have some deep sutures used to close the wound that are about to "spit" out.  This can happen.  Talk to your surgeon.

Stuart H. Bentkover, MD
Boston Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

Scar healing after a MACS lift

it appears from your photos that you have some degree of suture or hair irritation in the hairline. If there are any deeper sutures that can be removed, they should be. That will allow the incision to heal but it might need a small revision done in the office under local anesthesia at some point. At times if the deeper sutures used to close an incision can become infected, or hair gets caught in the incision, that can happen and then the incision looks like yours does.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.5 out of 5 stars 13 reviews

Scar healing after surgery

I agree with the previous authors stating that the scar healing takes between 6-12 months and in some cases longer. It is also not uncommon for one side of the body to heal faster than the other. There is an interesting theory that right handed people heal faster on the right side and that left handed people heal faster or better on the left side. I do not necessarily subscribe to this theory, however overall one side usually heals faster for some reason.

The scar healing is a process that the scar goes through while it matures. Early after surgery the scar is pink, may be tender and sensitive. As it continues to mature it acquires whitish characteristics. In individuals with darker skin the final scar may be actually darker rather than lighter.

During facelift surgeries surgeons generally place several layers of sutures to maintain the position of the skin and deep muscle. Some sutures may be more reactive and create more inflammation than others. Some patients may have difficulty with absorbing the sutures, because you are so early from surgery it is possible that your body is going through the early healing stages and may be having a little difficulty with the suture material breakdown. When the body is unable to break down the suture it will commonly spit it out and that may be the cause for the small openings. Fortunately, in those cases once the suture is removed or has come out the inflammation decreases and the scar heals. It is very important to discuss your concerns with your plastic surgeon to make sure that there are no other issues such as an infection. I don't think it is fair to expect that someone is able to diagnosis an infection based on a picture placed on the internet. However, follow up care is a part of the overall facelift process. I am confident that your surgeon will not be offended by your questions or concerns.

Boris Volshteyn, MD, MS
East Brunswick Plastic Surgeon
4.0 out of 5 stars 9 reviews

Healing after a MACS lift

The problem may either be hairs growing back through the incision (which will help conceal the scar in the long run) or a reaction to dissoluble sutures.  It will get better with time.

Michael Philbin, MD
Edina Plastic Surgeon
4.5 out of 5 stars 7 reviews

Is this normal healing?

Scar healing is a process that takes 1 year to complete. The first 3 months are normally the most objectionable and the incisions appear pink, inflamed, and thick. Over the subsequent 3-9mo, they significantly soften, lighten, and become less noticeable. If one side is having significant differences from the other, I would have your plastic surgeon take a look. Scar healing is rarely perfectly symmetric, but it is also uncommon to have major differences from side to side. I hope this is helpful!

Bryan Correa, MD
Houston Plastic Surgeon
5.0 out of 5 stars 9 reviews

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.