8 weeks post-op, still swelling after MACS Lift and Lipo? Is it possible that the bumps are still fluid? (photos)

Question

8 weeks ago, I went to the clinic for My macs lift and liposuction under chin. the results looks great for two weeks. After four weeks there appeared an inflammation under my skin.(see picture) I got antibiotica for 7 days, but 2 weeks later the inflammation was back.(again antibiotica ) I am so sad About the bumps under My chin. My ps said we must give it time to heal, and maybe a correction (little lipo again under the chin) afterwards. Is it possible this bumps are still fluid? Or do I have to worry?

Jonathan Kulbersh, MD · Answer

Thank you for your question and I appreciate your concern. It is possible you simply need more time to heal, but if you are concerned about the residual lumpiness under the chin, a second opinion is also an option for you. Always choose an experienced, board-certified facial plastic surgeon for procedures like these to minimize potential complications and maximize your outcome.

Jeffrey R. Raval, MD, FACS, MBA · Answer

It's a little hard to tell from the succession of photos, but a lot of this should subside in a few more months. I would schedule a follow-up with your board-certified plastic surgeon if you continue to have concerns. In the meantime, we have a very helpful resource to help understand what to expect with a face lift procedure. Take a look.

Timothy Treece, MD, FACS · Answer

At 8 weeks the incisions and contour should be settling down.  It is hard to tell from your photos, but you seem to have more contour variation than average.  If you are concerned about your surgeon's response there is no harm in getting a second opinion from a board certified plastic or facial plastic surgeon!

Jed H. Horowitz, MD, FACS · Answer

Throughout the #facelift #healing process you should be seen frequently by your doctor and one of their registered nurses to ensure you are following instructions properly and your recovery is going well. The healing process in general can take up to one month for the majority of swelling to subside, incisions to close, sutures to come out, and for bruising to completely go away. #Recovery time from a #facelift varies from person to person, but patients can generally expect to be presentable within three weeks from surgery. Patients should expect swelling, bruising, and discoloration of the skin during this phase of recovery (swelling normally goes down after 48 hours; most bruising will go away within two weeks). The marks from a facelift can easily hidden with “camouflage” make-up which you can learn how to apply.At this point into your healing, it may best to call your board-certified surgeon or their medical staff and discuss those #concerns.  Your procedure should always be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for another revision surgery.

Adam Goodwin, MBBS, FRCS(Plast) · Answer

so the redness at 2 weeks indicates a late infection so i agree that antibiotics were ag good idea at that point. It is normal post liposuction to get a phase of lumpiness as the layers stick to each other. It is only when the adhesions remodel that the situation improves and this might take 3 months or so. Keep patient and hang in there and i suspect that this will settle on its own. Hope that helps. Adam Goodwin

Gary L. Ross, MBChB, FRCS · Answer

This looks to be more than just a MACS procedure. I would check with your PS what was done in the anterior neck. The submandibular glands sit in the area that you feel is swollen and you may have some residual scarring from the lipo in this area. A lot of this will settle but without knowing what was actually done it is difficult to advise.

Joseph L. Grzeskiewicz, MD, FACS · Answer

You have provided a number of pictures, but unfortunately, they are all different in angle, lighting, and time course.  You have also provided no preop images, so it is hard to say whether those bumps might be due to structures that were present before surgery or not.  It also doesn't appear as though you've had a "classic" MACS procedure, in that you have a scar under your chin.  This looks as though you may have had more done to your neck and area under your chin than just liposuction, as we would typically see in a "classic" MACS.  This makes me concerned that the appearance of your neck has more to do with overly aggressive removal of fat and perhaps some manipulation or alteration of your platysma muscle, which is the thin sheet-like muscle in that part of the neck.  These bulges look awfully suspicious for either the paired digastric muscles in the neck, or the submaxillary glands, which are two large salivary glands right under the edge of the mandible, both of which are found in just that location.  Normally, the salivary glands are "tucked up under" the edge of the mandible and covered by fat and the platysma muscle, so they aren't readily visible.  Sometimes they will "fall," or descend, as their attachments up higher weaken, and if fat is removed overly aggressively, this can accentuate their appearance.  Of course, it is impossible to know this for sure unless one has the opportunity to view preop images and examine you in person, but this scenario is common enough that I would put it high on my list and look into it before I ever underwent another procedure to correct this deformity, especially liposuction.  In fact, if those are your salivary glands, further attempts at liposuctioning them directly to make them go away could be catastrophic.  If your surgeon hasn't already mentioned this possiblity to you, it may be worth it for you to ask him about it directly.  If he still does not entertain the possibility, I think it might be worth a simply second opinion just to put the issue to rest.  Best of luck to you.

8 weeks post-op, still swelling after MACS Lift and Lipo? Is it possible that the bumps are still fluid? (photos)

Answers (7)

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