Seroma and Keloid after facelift, any advice?

Question

Hi I had a macs facelift 8 months ago. I developed a seroma after surgery. I spoke to my surgeon various times regarding the lump but he did nothing about it and did not tell me what it was. He made no mention of draining it. It then drained itself through the stitches at the bottom of the ear. The skin then began to breakdown and a hole formed around the ear. I now have a keloid scar. My surgeon said it will fade but I have very little faith in him now. Any advice would be appreciated.

John J. Martin, Jr., MD · Answer

It appears that the skin never healed after the surgery which is unusual after 8 months.  With a seroma, you get a collection of fluid under the skin.  IT is usually pretty obvious, and the patient often states that they can hear the fluid when they move the head.  I have never seen one drain on its own but that may be because I drain them.  You will need to have the wound opened and reclosed in this area.  And old scar will be removed at the same time. A keloid is a very wide and raised scar, usually either red or white.  It does not look like this.

Boris M. Ackerman, MD · Answer

Fluid collection after a faceliftSeromas are quite uncommon after a facelift, especially 8 month later. 
 Your presentation suggests a reaction to some type of a permanent suture used 
during your facelift.  Ask your surgeon to get a culture test, to assess for a 
low grade chronic infection.

J. Kevin Duplechain, MD, FACS · Answer

This actually looks like a non healing wound or a wound not completely healed.  I would agree that you find a surgeon who is  willing to help you with some local wound care until the wound has healed.  You may consider laser resurfacing over the next few months, before cutting the scar out and starting over.  Light skin resurfacing can significantly improve the apperance of poorly healed wounds

Ryan Neinstein, MD, FRCSC · Answer

I am sorry you had to go through this. At this point I would want to make sure you are not having an ongoing infection. I would wait 6months after everything as settled and offer a revision. Either changing the colour with a laser or cutting out the old scar with revision surgery

Donald Nunn, MD (retired) · Answer

You need to have your face evaluated by another surgeon to make sure the infection has resolved.  Once that is taken care of and the wounds are well healed, not draining, and mature you could consider a revision of the scarred area.   Good luck.  Donald R. Nunn MD  Atlanta Plastic Surgeon.

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

Thank you for your question and photo. The photo is hard to interpret. It does not look like a keloid but looks as though it is an open wound. A keloid or hypertrohic scar should be dry, red, raised and itchy.From the photo it looks raw, open and wet-if it is then the skin has sloughed and the wound is open.In either case I would consider a revision-excising or removing damaged tissue and carefully re closing the incision.If your surgeon is unwilling to do this I would consider consulting a plastic surgeon who is certified by the American Board of plastic Surgery and experienced in facelift siurgery.

Seroma and Keloid after facelift, any advice?

Answers (6)

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