My MACS Incision is Not Healed and I Am Almost 4 Weeks Post-op? (photo)

My ps salid it will be fine. She told me to clean twice a day with Q tip and Peroxide and then cover with Bacitracin Zinc. I have been following this routine religiously ( also massaging gently with finger near incision to promote circulation. The area looks red and a bit puckered. The other side looks great ( healed in like 13 days). Is the ointment (which keeps it moist promoting or hindering healing at this point?). I just don't see an improvement from the last 8 days.

Doctor Answers 17

Delayed Healing after MACS Lift

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Thank you for your story and pics. From the details you provided, and the image, it looks like some of the skin at the edge of the flap is sloughing. This can be from too much tension on the wound or from a compromise of the blood supply to the area. Four weeks out, unless there is any pus, I would recommend stopping the bacitracin and peroxide. This can contribute to irritation and dry out the skin edges.  The other possibility is that you have had a reaction to a suture in the area, and the body is pushing it out.  Either way, it will be important to work with your surgeon to ensure proper wound care as the healing progresses.  Best of luck!

You may be extruding a suture above your left ear, following your MACS-Lift, short scar facelift.

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I read your concerns and reviewed your photos:

The bluish discoloration in front of the top of your left ear is the site of placement of the MACS-Lift suture knots, and you appear to have inflammation in this area 4 weeks after your procedure. If the rest of your face looks good, it may be best to observe this area, since suture removal this early may lead to unwanted changes on the left side of your face.

Feel free to re ask your question with more photos.

Certainly follow up with your surgeon on a regular basis until this is resolved, or seek a second opinion so you could see what might be best for you.

Hope this helps.

Dr. Joseph


Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Delayed healing after MACS face lift

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Thank you for asking about your MACS face lift healing.

  1. This delayed healing can happen after any face lift.
  2. The face lift scar may end up fine or need a slight later revision.
  3. I do not recommend peroxide or antibiotic ointments to any patients but prefer saline (salt water) washing and topical Aquaphor. They are less irritating.
  4. Have your surgeon see you to be sure the face lift wound is not rejecting sutures - it will stay open until all these sutures are out. Best wishes. 

Wound healing problems

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You appear to have some necrosis;  this tissue will either slough off of need to be removed by the plastic surgeon.  Most of the time these will heal well if no infection ensues.  In some cases minor scar revision may be needed at a latter date.  Close follow up with your surgeon is needed.  Donald R. Nunn MD  Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 51 reviews

Poor facelift incision healing

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From your picture it appears that the skin flap suffered diminished blood supply likely from too much tension.  When this happens, some of the tissue may necrose.  For a wound to heal, this necrotic tissue needs to be debrided.  This can be done in the office.  Once this tissue is gently removed, the wound can start healing properly.

Facelift incision not healing

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Thank you for your question and photos.  I'm sorry to hear that you are having some healing problems.  On occasion, wound healing issues can happen, even in facelifts.  With these type of wound issues, letting it heal by itself is the best way to manage it.  With a facelift wound, it is often a tightness/blood flow issue and the body will slowly take care of it.  Peroxide can often irritate the wound and while it helps kill bacteria, it may not be the best long term option for wound healing.  Keeping the wound moist with bacitracin is very helpful.  It is also helpful to make sure there are no sutures in the wound that may be delaying the healing.  Continue to keep in close contact with your surgeon and they will guide you through this process.

Best of luck.


Brian C. Reuben, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 37 reviews

Patience Is Bitter, But Its Fruit Is Sweet

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Delayed healing along the suture line is a common post-operative complication of facelift surgery. It can have many causes, including excessive tension on the closure, vascular compromise of the surgical flaps, hematoma, infection, etc.  

In your case, careful examination of your photograph suggests the presence of a small area of blue covered by the bacitracin ointment at the superior extent of the incision.  This may represent an exposed suture (probably prolene), that may be causing an inflammatory reaction that is contributing to a delay in healing. It may be helpful for your surgeon to trim this suture to promote wound healing.  

Additionally, I would recommend that you cease the use of hydrogen peroxide, which has been demonstrated to be cytotoxic to cells. Good old soap and water, in addition to a thin layer of bacitracin, should be sufficient to promote the healing you seek.  The good news is that if you are patient, your wound should completely close in a few more weeks. 

Peter Lee, MD, FACS
Los Angeles Plastic Surgeon
4.6 out of 5 stars 49 reviews

How long does it take for a facelift incision to heal?

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 Dear Lalu

Im sorry to hear you are having difficulty with the healing process after your facelift. This can be frustrating, but keep hope, this will certainly get better and WILL heal. 

From your photo it looks like there is still quite a bit of redness and perhaps even some amber colored crusting at the top and the bottom. If your surgeon is confident that this is not an infection that needs to be treated, I would try a couple of things:

Stop using the peroxide and use only mild soap and water (like Neutrogena) twice a day. Pat the wound dry with a clean towel. 

Stop using the Bacitracin. I have seen patients develop inflammation on the skin after irritation from prolonged antibiotic ointment. Use good old Vaseline instead. 

Make certain to stay in close contact with your surgeon and remain confident that this will improve. I hope you enjoy the results of your facelift. 

Best Wishes

Dr S

Travis L. Shaw, MD
Richmond Facial Plastic Surgeon
4.8 out of 5 stars 22 reviews

Delayed healing of a facelift incision

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Lalu, occasionally facelift incisions can be a little slow to heal.  You may be overtreating the area.  I would consider changing the hydrogen peroxide to a mild soap and water and discontinuing the bacitracin and using aquaphor instead.  Be sure to touch base with your surgeon if you don't see any improvement in the coming weeks.


Good Luck.

Anthony E. Brissett MD

Anthony E. Brissett, MD, FACS
Houston Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Delayed Facelift Incision Healing

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While there is delayed healing on this side of the facelift, it is a problem that will be short-lived as complete healing is inevitable. I would stop the hydrogen peroxide and only apply a very small amount of antibiotc ointment. Otherwise do not be afraid to get it wet with soap and water in the shower. It will be a few more weeks but you will start to see it close by then. See your surgeon in the next week to be sure there is not a deeper suture trying to extrude which can often cause a chronic inflammatory reaction at the incision line.

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.