Tightness and discomfort 4 years after facelift. Only help has been low dose muscle relaxant. Why chronic discomfort and pain?

Experiencing pain four years after a facelift is almost unheard of. I would have to review your operative report to see if there was any identifiable reason. I certainly would get a couple of opinions from board-certified plastic surgeons.

Would you are describing is extremely rare, but a definite entity which can be seen after a facelift. Facelift usually involves tightening the lower face as well as the neck. In the overwhelming vast majority of patients, this tightening is very well tolerated, and if there is tightness, it subsides within a few months. In your case, for some reason, it has not. This could potentially be that the tissues are in fact very tight still, or it could be some consequence on the nerves in the area which are perceiving tightness though things are not. I would visit with your plastic surgeon again, or others, and get examined.There are no well-defined solutions to this problem. Potential options could include, Botox, diffuse very dilute steroid injection in the hopes of softening scar tissue, an aggressive regimen of ultrasound and massage, etc. However, the first step would be to discuss this with your plastic surgeon, or other plastic surgeons, for some outside-of-the-box plans.Best of luck!Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

Thank you for your question.Where exactly is the pain?  When did it appear?  Pictures?I would consult with your plastic surgeons again.  Botox can help some muscle spasms.  I have also used a non-therapeutic dose of antidepressor amitriptyline in the past at a very low dose for 3 months with success.  But make sure you discuss first with your plastic surgeon and with your family physician.Hope this helps!

Best regards,Dr. Marc DuPere, Toronto Aesthetic Plastic Surgeon

It is very unusual to have pain this far out. I have never seen such a case. I would consider an MRI to rule out other causes. 

It is rare to have tightness this far out from a facelift.  It sort of begs the question as to what was done originally.  You need to be evaluated, preferably by the operating surgeon, and you should get your operative report and take it with you to any visit you have.The most likely remedy would include stretching exercises. Sometimes ultrasound therapy can help.  If there was something strange done in surgery, such as the placement of permanent suspension materials, they may need to come out.