4 - months out from lower face lift and platysmplasty. What would cause the operative sites to feel hard and inflexible?

My skin feels leathery, and my face feels hard in places. There is a lot of tightness with pulling sensations in my neck and around the ears. Prickling/burning/itching---feels like I'm wearing an iron mask that's lined with Brillo. It's extremely uncomfortable. Thank you for your response.

Doctor Answers 9

It's difficult to answer this question without more information.

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Hello, I'm relatively new to Realself.  I like the forum in general, however it is difficult to answer some questions without seeing the patient or photos of the patient.  It is always best to ask your surgeon all of your questions.  Hopefully you get reasonable answers.  In your case, having leathery feeling skin can be normal.  If your skin feels different then one reason is the sensory nerve innervation to the skin that was disrupted from the facelift.  Small nreves get transected when your skin is cut.  The nerves typically heal within a few months of surgery.  It is possible to have permanent numbness or sensation changes to the facial skin after undergoing a facelift.  The firmness you feel should also subside with time.  Massage may help.  External ultrasound may help also.  Are the scars flat or raised?  Another reason for these issues would be if you have very thin skin or the plane of dissection was too close to the dermis (deeper layer of skin).  You may have scarring or adherence in areas that may have resulted from hematoma or the surgical technique itself or from your own inherent ability to heal.  Again, I am rattling off ideas with no exam and little information.  If you post photos you will get more responses.  Good luck.

"This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."


Henderson Facial Plastic Surgeon
4.6 out of 5 stars 23 reviews

Did you have a postoperative hematoma?

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By four months most patients have a bit of residual numbness that no significant complaints as you describe. Any significant firmness should have long since disappeared. If you had an untreated postoperative hematoma this might explain the persistent symptoms.

Hard, leathery incisions after face lift

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Thank you for your question about your face lift.

Your description suggest that you have feelings that often occur after a face lift - the result of
  • irritated nerves that have not yet made contact with your skin.
  • still swollen skin but 
  • If you are concerned, return to your plastic surgeon to be sure all is well.  

Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.

4 months out from post surgery

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Without photos I can only speculate and not conclude a diagnosis, that being said the symptoms you describe sound like normal healing of nerves and incisions. However, if this continues to be bothersome or you experience signs of infection, consult with your surgeon.

Edward E. Dickerson, IV, MD
Fayetteville Facial Plastic Surgeon
4.7 out of 5 stars 127 reviews

Feeling tight after a facelift can be normal

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feeling tight after a facelift can be normal as the surgery tightened your skin and underlying tissues.  It can take time for the tissues to stretch to a point that they don't feel too tight.  The prickly/burning/itching sensation is nerves healing.  If this bothers you speak to your surgeon about medication for irritated nerves.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 518 reviews

Facelift issues

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It sounds like you need to be seen in person, and the best person to supply you with answere would be your surgeon. Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Firmness, Prickling, Tightness, Burning and Itching 4 Months after Face and Neck Lift

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You are describing very well some of the normal aspects in healing after facial rejuvenation surgery. Although certainly not everybody experiences the same combination of feelings, some of these is part of every patient's facelift recovery. The firmness represents remnant swelling and the other sensations represents the healing associated with sensory nerve endings. Follow up with your facelift surgeon to keep him/her "in the loop". 

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews

Tightness and prickly feelings in neck and around ears 4 months following a facelift

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It can occur quite often still at 4 months that one experiences symptoms like these after a facelift and platysmaplasty. Everybody heals differently and sometimes with a lot of scarring and inflammatory reactions in the incision lines or under the skin. If actual thickening is palpable in the areas of surgery a steroid injection into the thickened area(s) may be beneficial. Otherwise gentle massage with creams or oils and time will always bring improvement at this stage.  It can take up to 12 months for the tissues to settle. 

Leonard Miller, MD
Brookline Plastic Surgeon
4.9 out of 5 stars 16 reviews

Healing after a facelift

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Generally speaking, it can take 6 to 12 months to completely heal after surgery. Please keep in touch with your surgeon or his/her clinical team to discuss your ongoing concerns.

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 124 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.