14 days post facelift, necklift & bilateral brow lift with lower lid blepharoplasty done in Costa Rica. I have a scar? (Photos)

Thank you for your pictures and questions. It appears that you have some flap blood flow problems and some skin necrosis and this will likely result in some wound healing problems. I hate to be the one to say this, but this is what happens when you risk your health to someone who is not a board certified plastic surgeon. I would suggest you find a local board certified plastic surgeon to help you through this process. And I would also encourage you to share your story with other patients who are considering surgical tourism.Wishing you the best!

That is a tough situation.  I think a wound care RN at this point is likely sufficient to help you get this healed.  It will likely take up to 6 weeks to epithelialize.  Currently it looks inflamed but not infected.  The resulting scar will be red or pink longer than with optimal healing.  I would keep it clean and use something like Stratamed or whatever your nurse suggests.  I assume you are not smoking.
Once it heals over, it might end up acceptable in the long run.  If the scar becomes thick, or the skin atrophies or you have pigment changes, then a consult with a board certified plastic surgeon is worthwhile.
It is frustrating for everyone when this happens.  Issues seem to be more common in patients who seek cut rate surgery out of country or with non-board certified local surgeons.  If you are seeking aesthetic plastic surgery, you will always be best off in the hands of an American Board or Royal College (Canada) certified Plastic Surgeon.  Having surgery close to home helps post operative care and follow-up since travel expenses can become significant.
Some situations are so bad it takes multiple surgeries to get it back into a reasonable result and others are not really recoverable.  The best surgeons in the world still have complications and unfavourable results - but they also generally will fix things to the best of their ability for their own patients at minimal to no additional expense.  Revising sub-optimal results can be very labor intensive and often a lot more work than the original surgery.   
In your case, things might look a bit rough right now but I suspect it might turn out okay once it heals.  Anyone currently contemplating out of country surgery because of cost should understand that it is a much greater gamble with your health and appearance than if you find a reputable, well trained and local surgeon with the correct specialty and certification.  

You appear to have some skin necrosis and wound dehiscence. You need to receive care from a plastic surgeon.

Face lift etc. done outside the USA with scarring and tissue loss. you need to see an experienced surgeon like Dr. William Portuese. This is an example once again why patients trying to  save money by having surgery outside the USA should  Think twice before having this done. 

Others have noted that medical tourism is appealing because what you see are the dollars.  What you ignored is that the quality of the work is often frighteningly terrible.  You will scar from this and the area in front of the ears will scar. Your face lift incisions will be visible once they have healed. You are loosing the density of the hair along the incisions and these changes are likely to be permanent.  Surgeons will be reluctant to help you.  However, you will likely find someone who will step in to help you.  When you have healed from this, please consider helping others understand why medical tourism is not a good idea.  Best to you.

This highlights the importance of seeing a board certified facial plastic surgeon or plastic surgeon whom you can follow up with frequently and conveniently in the post-operative period.  US boarded surgeons are held to a higher standard and can treatment patients with greater competence than those engaged in medical tourism offering discounted plastic surgery.  Having said that, complications can happen following surgery even when performed by the best of hands. It’s how you are treated afterwards that makes the difference and this is where the problem with traveling to substandard locations for plastic surgery lies. Skin necrosis in front of the ear is a rare but known risk following face lift surgery. It can be caused by a multitude of factors but is ultimately the result of lack of adequate blood supply to your skin. This will take weeks/ maybe months to fully heal over. You can except some scarring in the area; however, with time, scar treatments, and makeup this should not be very noticeable as time passes. Aggressive treatment at this stage would include oral trental, topical nifedipine or nitrobid, hyperbaric oxygen therapy, and local wound care with frequent and close follow up.  The most important thing to do at this stage is keep in close contact with your treating surgeon. Hang in there!  

Thank you for your question and pictures.  That is a major downside with having surgery at a distance, you need regular follow ups with your surgeon to give your wound the attention and care needed if you have a problem.  You have developed skin necrosis on the right side of your face.  This will require medical attention.  Necrosis normally happens in patients which smoke.  Please try and find a surgeon locally to you who can offer you advise and clean and keep an eye on your wounds.  All The Best 

Very sorry about your experience; you definitely need to be under the guidance of a Surgeon.  The major problem with medical tourism is the time and distance required for follow up, especially in the event of a complication.  There are many qualified facelift plastic surgeons in Seattle who can help you.

Based on your photos, it does look like you’re experiencing some complications with the healing process, including tissue necrosis. Unfortunately, complications like this are quite common when traveling to another country for a plastic surgery procedure, especially in order to cut costs. Your best bet is to find a board-certified plastic surgeon in your area to advise you on the most effective wound care and possibly a surgical revision. Hope this helps.

Dear dkduble:
While I don’t have the opportunity to fully evaluate you, sharing your photos are helpful.

Your incision sites look reasonable and unfortunately, the farthest edges of the skin flaps have a loss of blood flow causing skin separation and necrosis. While complications following facelift such as yours occur in the US as well as with medical tourism outside the US, having a responsible physician nearby will lead to an earlier and possibly more favorable outcome.

Since I don’t know the actual number of days since your procedure and your photos, I would recommend you visit your Primary Care Physician, a Board Certified Plastic Surgeon or ENT Surgeon or be evaluated as soon as possible at your closest Emergency Room.
It is hard to estimate the progress of your wounds.There appears to be long standing bruising of the mid and lower face which may suggest underlying fluid such as a hematoma which needs drainage.
If there is progressive infection, it must be diagnosed and treated.
While Santyl is an option for open-wound care, it can be painful and not my first choice of care for what I see on the photos.
When properly treated, the wounds will heal and many options depending on your scar requirements are available to improve their appearance.
I hope this is helpful. I wish you the best.