Hardening and lump after hematoma evacuation on cheeks following a facelift. Will this go away?

2 1/2 weeks post op. i developed hematoma day after a facelift. blood was drained for ten days (it was serum mixed with blood at the end). my face would appear thinner after drainage (my face is thin). they stopped draining because (no more fluid). however, days later the sides of my face hardened and my face is now thicker and lumpy where the hematoma/seroma was. so at 2. 1/2 wks. it looks worse! the two lumps at the side of each cheek make my face look thick. no bruising.. help!

Doctor Answers 13

Dr. Jeffrey Epstein Answer

These areas of hematomas can take time to heal up. I find that a combination of massages, application of heat pads, and occasional steroid injections can help this process along.

Miami Facial Plastic Surgeon
4.7 out of 5 stars 128 reviews

Lump after Draining Facelift Hematoma

Hematoma under the facelift flap is an uncommon but well-known complication. In the majority of cases, this can be treated in the office with needle drainage.  In rare cases, the incision must be opened.  Regardless, with attentive care, the area should heal without issue.  The healing may be a little slower in this area, and occasionally there may be some subtle bumps.  These can be treated with massage or small doses of a steroid injection.  Most all, be patient and stay in touch with your surgeon!

#San Francisco Facelift

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 110 reviews

Be patient!

When you get a hematoma, there is more inflammation and swelling, so the side with the hematoma will always be a week or so behind in healing than the other side (so it will seem firmer and bigger).  However, in my experience, the tissue will soften and in the end, probably heal just fine.  So try to be patient and as the weeks and months go by, I predict that you will do very well.  Most importantly, speak to you surgeon about these concerns.

John Frodel, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 1 review

Hematoma after facelift

Thank you for your question and for sharing your experience with us. I'm sorry you developed a hematoma after your facelift. Hematomas are usually a result of bleeding in the tissues that is significant enough to cause a visible mass or lump that may or may not need to be drained depending on the size and location. Occasionally, it can be due to a bleed in the artery that may result in a more rapid, expanding hematoma and is usually a cause for more emergent treatment. Spikes in blood pressure, or vasodilation with increased activity can cause a small hole or tear that was previously sealed to open and cause the bleed. This is very uncommon for this to happen, and even less common after 10 days. Swelling after evacuation will persist longer than the unaffected side but should eventually return to a non-swollen baseline. In addition, the affected side may also appear much firmer and take longer to soften than the unaffected side.  I would follow-up closely with your surgeon who can help monitor the progress alongside with you.

Young R. Cho, MD, PhD
Houston Plastic Surgeon
4.8 out of 5 stars 35 reviews

Give it time

You are early in the healing phase, give it more time (say 4 to 6 months) to get an idea if the area is improving.  Usually the hematomas are taken care of by local drainage but sometimes you need to take the patient back to the operating room to correct/repair such complications.  Speak to your doctor and find out what his/her recommendations are.

Andre Aboolian, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 60 reviews

Hematoma after facelift

A hematoma can be an unfortunate complication following facelift surgery. The tissue inflammation that results can create swelling and hardness that delays the healing process. While frustrating, a hematoma rarely affects the long-term result. Be patient and make sure to be compliant with your surgeon's instructions. 

Dr. Miller

Todd C. Miller, MD
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 34 reviews

Facelift Hematoma

Facelift hematomas are an uncommon complication of facelift surgery.  Although uncommon, they can occur and when treated they usually will heal without consequence. 

Most hematomas can be drained by the facelift physician in the office to decompress the area. This may or may not  necessitate several drainage sessions. Once the hematoma has resolved it is possible for that area to have some hardening and/or even dimpling. Fortunately this tends to resolve completely. Massage of that area and/or steroid injections can help facilitate a quicker resolution. Discuss this with your surgeon.

Jacob D. Steiger, MD
Boca Raton Facial Plastic Surgeon
4.9 out of 5 stars 60 reviews

Seroma after face lift

Your face lift tissue lumpiness after the hematoma is a natural part of healing after infection or hematoma.
It will take months to improve. Steroid injections may help - but can make the face lift tightening looser. 
Sorry about your complication. Best wishes.

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Scar Tissue After Hematoma Treatment

Sorry to hear that you had a hematoma but it sounds like it was treated appropriately.  The hard lumps most likely represent healing tissue that will resolve over time.  Tissue massage in that area may help but frequent follow up with your PS will be you most affective treatment at this point.

Earl Stephenson, Jr, MD, DDS, FACS

Postoperative hematoma can create a lump that will take weeks to go away even after evacuation.

What you are describing is fairly common after evacuation of the hematoma. This will gradually resolve over time but you should be seeing your surgeon fairly often so he can chart the course of your convalescence.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 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.