Skin sloughing after facelift - make up consultants in adjoining clinic were first surprised, then said it is good/lucky result.

Question

I am 50, had a facelift about 8-9 days ago by trusted surgeon. I had almost NO bruising, but bad/hot swelling (now better). Past two days my skin is peeling/flaking, like after a very mild sunburn or a great exfoliation. I assumed normal, surgeon said I look great but did talk about a harsh wash he uses. Started in the corners of my eyes and mouth, but now it is all over the forehead and cheeks. I do not smoke, have heart disease nor diabetes. I am confused - is this normal or a complication?

Richard H. Tholen, MD, FACS · Answer

Let's be a little more precise about terminology. "Skin sloughing" sounds like full-thickness dead skin loss leading to raw open wounds and disfiguring scars--something that might be seen after ischemic healing problems such as in a smoker.But "peeling/flaking" of the topmost dead layers of the epidermis like after a "very mild sunburn or great exfoliation" is an entirely different kettle of fish, so to speak!Surgical scrubs are designed to remove dead cells from the skin surface, as well as cleanse the pores, hair follicles, and sebaceous glands of as many bacteria as possible prior to an operation--so "harsh" may in fact be one way to describe a pre-surgical wash, whereas "thorough" or "efficient" might be another way to describe the same thing!While this exact type of response is not commonly seen in most facelift patients, there are many shades of gray between "normal" and "complication." What you are describing is certainly NOT universal to every facelift patient, but neither is it something "bad" or worrisome. We do know that inflammation can definitely stimulate production of new collagen and elastic fibers in the skin, and this imparts a tightening (beneficial) effect on the superficial layers of the skin, whereas a facelift tightens deeper layers. That is why a chemical peel or laser resurfacing performed 6-12 months after facelift surgery can give results superior to facelift alone (or peel/laser alone.)It sounds as if the unusual significant ("bad/hot") swelling seen in your individual case, perhaps also associated with that "harsh" (or effective) surgical scrub, could have been the cause of those top layers of skin peeling, and that "sloughing" (but let's call it peeling of the top dead layers of the epidermis) indeed can enhance an otherwise "usual" outcome instead of sounding so dire!  I don't think the estheticians at the surgeon's skin spa were lying to you (or giving a "positive spin" to a complication)--I think they were telling the truth in a way to defuse anger or concern about what you are wondering might be a possible complication. You obviously were bothered enough to ask, and your concerns should never be taken lightly, though your description quite accurately tells us this is likely nothing to be concerned about! Without seeing you, it is of course impossible to reassure you definitively, but I would feel safe in telling you "Fear not, fair maiden!" Best wishes! Dr. Tholen

Stephen Prendiville, MD · Answer

Although photos would be much more helpful, your description does not sound like what we as Surgeons would describe as a skin slough.  Antibacterial scrubbing material is the standard of care for any surgical procedure and is in your best interest. If it concerns you, immediately return to your Surgeon for evaluation.

Michael I. Echavez, MD · Answer

Photographs or an examination of you would be helpful to give you the best advice as to your recovery 8-9 days after your facelift.  It is possible to have some flaking and/or peeling of the skin after a facelift.  If the skin itself is not dark in color, I would not be too concerned.  It is also possible your skin could be reacting to something that may have been placed on your skin topically.  I would discuss your concern with your surgeon to determine if there may be something you can do to improve the issue.

Gary L. Ross, MBChB, FRCS · Answer

Very difficult to comment without some photos. I would send some photos to your PS for advise as it is unusual to be shedding skin at this stage unless you had a resurfacing procedure at the same time as the facelift.

Skin sloughing after facelift - make up consultants in adjoining clinic were first surprised, then said it is good/lucky result.

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Skin sloughing after facelift - make up consultants in adjoining clinic were first surprised, then said it is good/lucky result.

Answers (4)

Answer: Facelift

Answer: Facelift

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