Raised Ridge Along Jaw Line 4 Mo Post-Op SMAS Lift, Is This Normal?

I am 4 mos post op after mini smas lift with absorbable sutures. There is a raised ridge along my jaw line about 1 inch in length just below ear. Could this be scar tissue below the skin where the skin was separated from the smas during the operation? Is this normal healing? Photo is attached. I have this only on one side of my face.

Doctor Answers 8

Ridge under skin 4 months after Face Lift

I have performed Face Lifts for over 20 years and this type of ridge could be caused by several things.

  1. Liposuction, under the skin flap that removed more fat below thus creating a ridge
  2. Excess scar tissue, under the skin
  3. Residual localised scar form using electrocautery to the undersurface of the skin flap
  4. Tear in the SMAS layer

 All but number one and four, should resolve with time and this could slowly disappear over the following 8 months...which is not unusual in traditional Face Lifts.  If it's still there after a year, it's most likely either a fat or SMAS issue that would require lifting the skin, over the ridge so the fat could be taking down or the SMAS sewn back together.

Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Ridge along Jawline after facelift

Ridges and lumps are normal after a facelift.  They begin usually around 2-3 weeks after surgery and can get fuller for 6-8 weeks.  They are usually present in front of the ear, below the angle of the jaw as in your case, or just under the chin.  It begins to resolve around 10-12 weeks and flattens from there.  Daily massage and possible steroid injections in the area by your surgeon may help the area resolve.  Of course, visiting your surgeon and having him examine the area is the best course of action.  Waiting is also a good option.

Mike Majmundar, MD
Atlanta Facial Plastic Surgeon
4.6 out of 5 stars 49 reviews

Lumps and Bumps along jaw line after a SMAS Facelift

Given that it has been 4months since your surgery this is most likely due to tethering of the skin or build up of scar tissue under the skin.

Either  way you need to see your Surgeon so they can examine it and see what exactly is happening - these are easy to remedy with local anesthesia and a small procedure.

Take care,

Dr. J

Kamran Jafri, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Ridge by Jawline after SMAS Lift usually resolves

Everyone wants an immediate result - including surgeons! Unfortunately this just isn't how we heal. four months is just too early to tell and I would NOT do anything surgical at this point. Your specific area of fullness is typical for certain types of SMAS lifts such as the MACS lift or others that suture in this area.

There are many predictable portions of the healing process that ALL PATIENTS EXPERIENCE. Although both doctor and patients would like to not have this happen, it is part of the healing process.  Massage can some times be of benefit during this time period These Side effects refer to what you will be experiencing from the facelift healing process: Here are some of the common things you will experience. The common side effects include: swelling which is maximum 2-3 days later, bruising (highly variable), numbness which takes several months to resolve,  tightness takes several days to months to resolve, discomfort chewing (technique dependent), discomfort (generally mild with this surgery, nausea (variable) and in some patients emotional lability in some. Although most of the visible edema resolves in 2-3 weeks in mini-lifts and 3-4 weeks in traditional facelift approaches, residual firmness (edema you feel but don’t see) can linger for several months. Skin suppleness also takes a while to return as does scar maturation. I tell my patients it takes up to a year for final resolution of the healing process. In my experience, the above rough time table is usually delayed in smokers, when multiple procedures are performed together and when resurfacing procedures are done at the same time as the lift. The same is true if complications occur such as infection, hematoma, skin loss or compromise, etc.  Facelifts and all surgical procedures for that matter share several possible complications - such as excessive bruising or bleeding (e.g. hematoma), injury to deeper structures, anesthetic complications and so on

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

Ridge Along Jaw Line after SMAS Lift

At four months following your surgery this ridge is not likely due to swelling.  The ridge could be a collection of organized hematoma, some fatty tissue, or a piece of the SMAS tissue.  I would start by doing some liposuction of the area with a very small cannula.  

Michael Sundine, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 18 reviews

Raised Ridge 4 Months after SMAS Facelift

The swelling is not normal. It may be the result of an irregularity in the underlying fat and muscle or scar tissue secondary to a small post-op hematoma. Massage and ultrasound treatment may be helpful or excision of the fullness under the skin with local anesthesia will eliminate the contour irregularity.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Ridge after SMAS lift.

This is not normal and you should see the surgeon for an excision of the excess scar that is there. This can be done under local anesthesia.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Face lift

The fold visible can be many things. A thorough examination by your surgeon is critical. This area of the neck cotains many structures and a precise diagnosis is important. it could be a remnant of a small hematoma  and resulting scar, it also could be an enlarged lymph node. a skin fold , a fold of the lateral platysma muscle.

So have your surgeon examine it and work it up then you can decide on the appropriate course of action

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 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.