Had lower facelift & CO2 laser 9 days ago. Mainly recuperating well, except lower right side of jawline and upper neck has swelled so badly, dr has drained 3 times. Left side is fine and less swollen each day. Dr. says he has never seen this level of swelling but doesn't seem concerned. Is this normal or could I have some compromised lymph situation going on? I have to return to work in six more days (15 days total), so if this is a complication, I need to find solution quick. Suggestions?
Is This Normal Swelling from Lower Face Lift?
Doctor Answers 9
Swelling after a lower face lift
At 9 days after a lower face lift, it is not unusual to still have swelling. From your description it sounds as if you have developed a seroma or hematoma on your right side. This can happen and I believe your doctor has treated it appropriately with needle aspiration. If the fluid collection persists he may want to place a small suction drain in the area for a few days. A light compression bandage should also help, but don't worry the fluid collection will resolve.
Recurrent swelling requiring drainage following "lower facelift" is uncommon
Recurrent swelling requiring drainage following "lower facelift" is uncommon. I agree with my collague that this is likely a seroma or resolving hematoma. Very uncommon causes include a sialocele or fistula. This would be very rare. Options for management include repeated drainage following by a compression dressing to prevent reaccumulation. If you followup closely with your plastic surgeon, this will likely heal just fine. Returning to work in 6 more days might be an issue depending upon how quickly the swelling stops.
Stephen Weber MD, FACS
Swelling after facelift
Dear facelift patient from FL,
The type of swelling that you are describing is not uncommon after a facelift and is what sound like something called seroma. A seroma is a collection of fluid under the skin which is a result of raising the face and neck skin with maniupulation of the underlying fat. As I said it is not uncommon and the body will eventually reabsorb the fluid if it is just a small amount. If it is a larger amount, occaisonally it will require aspiration which may need to be done a few times as they can reaccumulate. Placing a drain and a compression dressing is something reserved for larger seromas which are not responding to simple aspirations. This may be an option for you if the fluid is not getting any better. It is improtant to drain the fluid is so that the skin can adequately tighten down for a smooth facelift contour and also to avoid potential infection.
I hope this helps,
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Lower facelift swelling requiring drainage 3 times is unusual.
Fluid collecting in the neck and lower face 9 days post-op lower facelift, and requiring drainage 3 times thus far, is not the usual course following this surgery. Your surgeon is aspirating the fluid, but this seems inadequate since it has required continued aspiration. If it is diminishing each time and further aspiration is unnecessary, then this is the way to go. But, if fluid continues to accumulate, you only increase your risk of lumpiness, irregularity, or less-than-ideal result.
Are you wearing elastic chin/neck support full time to help reduce fluid accumulation and assist in "sticking" the skin down to the underlying tissues? This is a huge nuisance, but essential, IMHO. Also, I would consider asking your surgeon if a small drain (can be placed under local anesthesia in the office) that allows constant drainage and full-time adherence wouldn't be a better idea than intermittent syringe aspiration. A drain might encourage the fastest adherence, and would allow you the best likelihood of returning to work on-time, but getting a good result long-term and following your doctor's advice is much more important than a specific back-to-work date. Good luck!
Swelling after facelift and CO2
If you had swelling drained three times, then this sounds like you have a persistent seroma. You may need to continue doing this until no more seroma is present. I would make sure that you continue to follow up with your plastic surgeon during this period of time.
Is This Normal Swelling from Lower Face Lift?
In my experience, the combined use of Co2 lasers with facelifting can impact post operative swelling times, secondary to the impact of these lasers on lymphatic drainage channels. The areas I have often seen prolonged edema are around the eyes and along the jawline. In my experience, this prlonged edema should not require drainage, and I am guessing you may have a seroma that is requiring extra attention.
One thing that helps in these situations is the use of ultrasound to help reduce tissue swelling. Physician therapists have these devices, and in my practice we like the Mettler systems best. I have found a few treatments with these devices can counteract the additional edema when Co2 is combined with facelifting. Good luck in your recovery.
Lower facelift swelling
One complication of facelift work is collections of blood in the surgical site (hematoma) and collections of serous fluid (non-hematologic fluid). Both need to be drained pretty much daily until they resolve. Some surgeons use pressure dressings, but this can harm the skin. Occasionally the wound needs to be opened and evaluated.
Swelling and serums are diffent animals!
Your recurrent swelling that requires drainage seems to suggest fluid accumulation - "seroma" - more than simple swelling - "edema". Seromas can be treated by repeated needle drainage, pressure dressings, or placement of a passive or active surgical drain.
The important thing is that your seroma gets treated and closely followed to speed your full recovery. It seems like your surgeon is involved in your follow up care - keep seeing him/her frequently until the sitution completely resolves.