How to soften scars and relax very tight muscles after facelift?

Question

Is it ok to take robaxin/methocarbamol after a face and necklift to ease tightness? Can prolonged edema contribute to pixie ear formation? Can it effect the outcome of face and necklift? I have very tight pulling/swelling am noticing widening scars that are very stiff as well my ears are starting to pull down and the tragus is pulling out. I get tension headaches constantly from the tightness. It looks also like tethering is occuring in front of my ear and under chin. Solutions? Thanks

Arturo Valdez, MD · Answer

Thank you for your question. Everything depends on what surgical technique was used by your surgeon. In my practice, when I perform a deep plane technique, this makes more tension and traction on the deep, underlying tissues. When a patient feels that their face is very tight, many patients assume that it's due to the traction of the skin when in fact, it's from the the deep tissues that have been pulled very tight causing the patient some difficulty or discomfort when trying to open their mouth. There really isn't any traction of the skin. When we elevate the flap and detach the skin from the deep tissues, the skin's sensory nerves react differently and often cause patients to feel as though their face is very full or badly swollen. Those sensations gradually fade over the course of 6 to 8 weeks after surgery, and the deep tissue tension will relax after the 1st month post-op . After which, a patient can do some massage. Most patients do not require any pain medication after the 1st week to 10 days after surgery. As for the pixie ears, this rarely happenes but, it could be due to improper incision placement and sutured it with excessive tension.
I hope this helps.
Wishing you the best.

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Zoran Potparic, MD · Answer

It would be very difficult to give you  meaningfull advise without in person consultation. It has beeen shown that injection of Botox into selected areas of scars or tight muscles/bands as well as corticoseteroids may help to softer and relax scars and muscles. In person, second opinion consultation, may help. Good luck.

Russel S. Palmer, MD · Answer

Sometimes, even though we want to go the more conservative way, a second procedure may be necessary. Have you spoken to your surgeon about a scar revision? That may be your best choice.

Connie Hiers, MD, FACS · Answer

You may have been pulled very tightly. You can try gentle massaging to help soften and relax your tissue. time will also relax your tissue.

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