Are my post-facelift spasms a response to swelling?

At 5 weeks, you are back to normal activities, bruising is gone, and scars are beginning to fade, so facial spasms occurring now (similar to the one you noted at 5 days post-op) can make you feel like "something" might be wrong. You still have additional scar maturation that will take several months to occur, and that includes all of the tissues beneath the skin's surface that you cannot see, but that are nonetheless going through the same healing, softening, settling process. You still note some swelling and likely some firmness in your facial tissues, further evidence that you are not yet maximally healed. This will likely take several months (4-6 or longer; every patient is different).

While I can't promise that this will never happen again, I can absolutely tell you that the likelihood of further facial spasms diminishes every day and week that you make progress from your surgical date. Relax and enjoy how much better you look! If you have further concerns, see your surgeon--he or she wants you to feel happy about your recovery!

5 weeks is still relatively early in healing process after your surgery.  There are still irritated nerves and tight and stiff muscles.  Be patient and continue to follow up with your surgeon as directed.

Brief infrequent facial spasms during the first 6 weeks after a Facelift are within normal limits and nothing to worry about.

This is simply the result of irritation of the facial muscles caused by the surgical dissection during a Facelift.

Sustained frequent facial twitching could be a sign of blood electrolyte imbalance post operatively or caused by a medication you are taking (Compazine) so if the twitching or spasms are frequent be sure you see your doctor.