1 month post-op facelift: firmness and indentations. (Photos)

Question

I have firmness and ridges in it and indentations On either side of my cheeks where I have have and continue with Bruising. Is there anything I can do about this? I continue with quite a bit of swelling and have been using ice packs. And mild massage. As well as Arnica gel. Initially following surgery I had a ridge on either side of quite profound bruising. Thank you.

Pejman Aflaki, MD · Answer

Hello and
thank you for the question. A lot of what you are experiencing should get
better over the next 3 months or so , with a combination of massage and at
times local injection of steroids to thickened/irregular scar tissue. Your
surgeon is the best person to guide your through the process. Please follow up
with him/her frequently. Best,
Pejman
Aflaki, M.D.
Johns Hopkins-trained
plastic surgeon

Thomas A. Mustoe, MD, FACS · Answer

The face should improve and smooth out at least partially over the next few months.  Your surgeon would in the best position to know whether this is scar tissue, lumpiness from fat grafting, from sutures or from an incomplete resorption of  blood after the procedure. Unfortunately this kind of lumpiness does not always full resolve. I would suggest close followup with your surgeon, and a second opinion if the problem is not improving.

David Gilpin, MD · Answer

Thank you for your question.  I would continue to patient with the healing process.  You are one month out, and still will have some swelling from the surgery.  This can account for the firmness and ridges you are feeling.  Sometimes after a facelift, it can take time for these irregularities to smooth out. Typically this will be fully resolved anywhere from 4-6 months.  Be sure to let your surgeon know about your concerns, as well.  I hope that this helps!-David Gilpin

Jonathan Kulbersh, MD · Answer

It is still too soon. You may still have some swelling, which will slowly resolve over the next several weeks. I do recommend following up with your surgeon about your concerns. I hope this helps.

Stan M. Valnicek, MD · Answer

Thank you for your question.  Some degree of contour abnormality can exist in the first few weeks after facelift.  This can be localized fluid or blood collections, knots from deep sutures, puckering at the transition of the undermined and intact area, or as a consequence of different vectoring of the deep layer (SMAS) and the skin.  It almost always settles down - but it can take 6-10 weeks.
Your are doing all the right things.  I would visit your surgeon regularly so they can follow the progress and help resolve the issue for you if it does not completely settle.

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Thank you for your question and pictures.  Please continue to massage, also steroid injections may help to speed the soften process up.  Each surgeon will have a different protocol, please follow theirs.  All The Best

Arnold Almonte, DO · Answer

The changes you’re seeing are not unusual after a facelift. At this point I recommend continuing gentle massage 2-3 times a day. These will improve with time. On occasion I’ve recommended ultrasound to speed recovery. Follow up with your PS in a few weeks.

Andres Bustillo, MD, FACS · Answer

The lumpiness that you are seeing is normal and will resolve with time. Gentle massages 2-3 times a day in circular upward motion will help, but please consult with your surgeon before starting these.

Jordan P. Sand, MD · Answer

Hi dkduble and thank you for your question and photos.
Following a facelift, small skin irregularities can be seen which can often be treated with mild massage. Injections of steroids into the area can also be helpful in selected indications. Residual coloration from bruising can be treated with IPL to help break up the pigment. Arnica, as you are using, can also help. I would recommend close follow up with your surgeon who can help guide you through the healing process and offer small touch-up treatments if they are necessary.
Good luck!

Paul S. Howard, MD · Answer

Your question is a good one and effects many who have a facelift under general anesthesia. Waking up in the recovery room is a blood pressure roller coaster which can cause collections of blood much like you have experienced. The problem is that you're doing about everything possible, it simply takes time causing your recovery to be uncomfortable- mentally. Since we started performing facelift under sedation with well thought out local anesthesia, your type of issue rarely, if ever, happens. It seems prevention is the best solution.

1 month post-op facelift: firmness and indentations. (Photos)

Answers (10)

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