Redraping of the skin after hematoma. Will it damage the skin?

Hematomas after a facelift can happen to good patients and good surgeons (about 1-2% of the time).  It's part of doing this surgery and having this surgery.  The key is to have a good partnership between surgeon and patient.In my opinion, here's the best approach to this problem.It's good to wait a year, since it takes a while for skin to soften up againAs long as you liked and trusted your surgeon, and as long as your original surgeon was a proper board-certified plastic surgeon (not another specialist who happens to do facelifts on the side or learned to do them over a weekend), it would be best to go back to that surgeon.  If that's not possible, seek out a proper board-certified plastic surgeon who is EXPERIENCED at facelift revision surgery.  This is critical.Revision of facelift, in my opinion, is not expected to damage the skin.Recovery depends on how much work has to be done.  It could be as little as a few days or as long as a few weeks, depending on the necessary work.The cost will depend on several factors, such as whether or not you need anesthesia, operating room, and the amount of time required for the work.Good luck, and again, make sure you have an experienced board certified plastic surgeon.

Unfortunately a hematoma is a risk factor of facelift surgery. That being said early identification and drainage are the keys. The overlying skin may be inflamed and have irregularities for awhile, however these changes with time will get better and better. In my practice I have used ultrasound with good benefits. If after the year mark there exists some laxity a redraping procedure can be done and is often beneficial. The costs will be dependent on the surgeons revision policy. Hope this helps!

Thank you for your question. Redraping of the facial skin after a hematoma should not pose any viabilty issues. You should though be evaluated in-person to make sure that the fibrosis has softened enough. Depending on the extent of undermining needed, it may essentially be a "revision" facelift. I hope this helps!

Dear "ooops" - this is an interesting situation . . . do you think that the hematomas were large enough to actually stretch the skin?  (Usually if severe enough they may cause the overlying skin to die; obviously good that this didn't happen).  There's a chance that the skin may be more able to tolerate redraping and tightening at this point (a "delay" effect in surgical terms, where the blood supply is actually enhanced), so I wouldn't worry as much about underoing a similar repeat approach (from which it sounds like you would benefit), unless the skin is already damaged or heavily scarred down.  If the issues are lateral/near the ear only, the recovery may be less significant than before, but if down by the jowls, you may be looking at something similar recovery-wise (although if they also did deeper tightening before at the "SMAS" layer, this skin-only approach may be less involved . . . )  Best of luck to you.

Sorry to hear about your prolonged recovery. I read many of the answers below and It seems like you are getting some good advice. Healing from a facelift can be very difficult and prolonged in some people. This is not common fortunately however as a surgeon, it is our job to help you through the process and ensure there are no complications that can not be repaired. It is common after a hematoma to have some fibrous and slightly abnormal appearing skin. This can be due to many factors and may be due to things like a deep scar contraction (the deep tissue forms fibers and can pull on the overlying skin). If you wait a year and this still is visible, there are some option to try. Rarely do you need to do a second surgery, so I would be cautious about that. One option is different forms of non-ablative radio-frequency treatments. This can heat the deep layers of your skin and help break down the small scar fibers. There is certainly no guarantee this would work, but I think it would be work mentioning to your treating surgeon.  This would also be substantially less expensive. Regardless, its difficult know the best option unless you could see your photo's or your face live. Hopefully this was somewhat helpfull,Dr James P. Bonaparte, MD, MSc, FRCSCOtolaryngology - Head and Neck SurgeryFacial Plastics and Reconstructive SurgeryOttawa, Ontario, Canada

Congratulations on your facelift.  I'm sorry to hear that your recovery was prolonged, but it sounds like you are making progress.  The question in my mind is what type of irregularity are you trying to fix and whether or not surgical intervention is necessary.  It sounds redundant, but photo evaluation and clinical exam is best in order to make a reliable recommendation.  However, some findings are consistent regardless. Hematomas do happen, and despite appropriate evacuation and drainage, prolonged edema and contour irregularities can happen.  Sometimes waiting 1 year is not enough.  Meet with your surgeon and evaluate your options.  Fillers/fat grafts etc can often temporize to get you through the healing cycle.  If skin elevation and re-draping is indicated, your surgeon will help you evaluate the appropriate time with regards to risks.

A significant hematoma will eventually resolve but will leave a sizable amount of scarring that may take years to totally flatten. In general, a large hematoma is removed completely at the time that it is recognized.

I think that the skin has to be evaluated. If it is still firm or feels fibrotic then it is best to wait.  An evaluation in person is best.

Hematoma is a known complication following facelift surgery.  It is rare to have bilateral hematomas.  First, I would have a sit down with your surgeon with respect to medications/supplements, etc that may make you more prone to hematomas.  Following that, redraping can be performed with excellent results.  The cost is variable depending on the surgeon's policies.  It is normally cheaper than a facelift. 

These are questions to ask your surgeon to answer after evaluating your face and neck. it is not unheard of to have a touch up after such a complication.