Post Op Lower Face Lift, 3 Weeks, Black Spot?

I am post op week three and have developed this divot in my cheek that is turning black. Now, I did have a MASSIVE hematoma and it was NOT evacuated; but this blackened spot (about the size of a dime) has now opened up on the outer layer of skin and is bleeding. I did have significant swelling on this same side....... Should I worry? I called doc and he said not to, but I am a CRNA and this looks necrotic to me. Plus, its very painful.........the whole side of my cheek now hurts very badly.

Doctor Answers 6

Dead skin after facelift?

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This is difficult to answer without a picture. You should have your surgeon look at the problem as soon as possible.

The black spot could be a blister, a bruise or indeed dead skin (necrosis).

The treatment is conservative with oral and topical antibiotics - the latter as an ointment - so as to prevent further loss of skin by infection. Bruising and superficial skin loss will recover but full thickness loss will lead to scab formation, separation and delayed healing with some degree of scarring.

However with time a scar will soften and grow pale. It may become amenable to revision at a later stage.

It is important to stay in close contact with your surgeon so he can monitor your progress, outline a plan of dealing with the problem (if one exists) and institute the most appropriate treatment in a timely manner.


Rolling Hills Estates Plastic Surgeon
5.0 out of 5 stars 5 reviews

Postop Hematoma

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A massive postoperative hematoma that wasn't evacuated isn't a very good scenario.  Regarding the black spot, this may represent skin necrosis related to your hematoma. However, I would recommend close follow up with your Surgeon.  Close follow up and wound care is essential in circumstances of delayed or marginal wound healing.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 103 reviews

Hematoma without Drainage and Skin Compromise

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    Hematomas, especially large hematomas, should be drained.  Any worries of skin compromise should be addressed as well.  Although there may be little to do at this point based upon exam, the plastic surgeon needs to be involved.  Kenneth Hughes, MD facelift Los Angeles, CA

Be seen immediately

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Having a massive hematoma that was not drained it obviously not good. You certainly can be a setup to having an infection or skin necrosis. You need to be seen by your surgeon ASAP.

Sandy Sule, MD
Dallas Facial Plastic Surgeon

Problems with face lift

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Sorry to learn you are having problem with face lift. From what you wrote it seems to me you have a problem. but without direct examination, it would be difficult to address your concern appropriately. You need see your plastic surgeon and address your problem with him/her. Being a CRNA I am sure you picked the right surgeon.

Moneer Jaibaji, MD
San Diego Plastic Surgeon

Face lift

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You need to be seen immediately. Call your surgeon and you must be seen to get a diagnosis and treatment before things get worse.

Samir Shureih, MD
Baltimore Plastic Surgeon

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.