Hematoma and scarring at the site of drained hematoma. it seems as it is liquifing in some areas?

Question

after facelift i developed hematoma on both sides. it was milked every day for a couple of weeks. then i developed scar tissues. ibegan conservative steroid injection ultrasound and light massage. the lumps are visibl especially when i smile. but while in massage them, some of them seem to be liquifying but dont reabsorb (some stay hard). my surgeon tried to go in with a needle but nothing comes through. what is that lump tnen? i have a blob of semiliquid stuff on my cheek and dont know what it is.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

A hematoma can be a devastating complication in facelift surgery.  Prevention is key starting with control of blood pressure before, during and after surgery in addition to superb surgical technique to make sure that all bleeding has been stopped prior to closing the incisions. Drain placement can be helpful as well. A hematoma can lead to infection, and skin loss due to pressure  as well as an unacceptable result.A hematoma should be treated aggressively initially.  This is typical by exploration of the site and complete removal of the blood and identification of the source of bleeding.  You may have to let the areas soften over many months and then reevaluate any need for revision.Earl Stephenson, Jr, MD, DDS, FACS

Vincent N. Zubowicz, MD · Answer

A properly drained hematoma should not cause any significant healing issues. Blood that remains undrained will create additional inflammation that can prolonged convalescence appreciably.

Roy A. David, MD · Answer

Dear angel, thank you for your question.  Swelling after a facelift may persists from
weeks to months, causing bumps or asymmetries to appear.  Follow up with your surgeon to check if this
is swelling versus something else and if treatment is indicated. Best of Luck.

Brooke R. Seckel, MD, FACS (retired) · Answer

It sounds as though your plastic surgeon is handling your hematoma problem correctly after your facelift.  In my experience small lumps and bumps created by a hematoma during a facelift eventually resolve with massage and time.  Typically this can take up to 6 months.  If this does not occur surgical revision can be donealthough this is rarely necessary.

George Commons, MD (retired) · Answer

Hematomas take a long time to resolve.  In my practice I prefer to take the patients back to surgery, open the cheek flaps, and thoroughly clean out the hematoma.   Hematoma is blood and blood in tissue is irritating and irritation causes more scar to develop.  At this point it sounds like the milking plan has worked.  Resolution wil take 4 to 6 months and some aspects take a year.   Hematomas do happen and test doctor and patient with longevity of care.  The good news is they do go away.    My Best,  Dr C

Hematoma and scarring at the site of drained hematoma. it seems as it is liquifing in some areas?

Answers (5)