Recurring infection after facelift. What could cause it?

Question

I had a facelift in May 2021. I healed fine but later noticed something tender and red around my left ear and sent pictures to my doctor, who put me on keflex. Two weeks later the same spot came back, and he prescribed me cipro this time. It went away and I was healed. Now another 6 months later (1 year from the surgery), I experienced another episode of the same thing, only this time I'm not responding to Keflex. After 4 days, it got more swollen and more red. What could cause this ?

Marc Polacco, MD · Answer

Thank you for your question. Although I cannot know for certain, it your surgeon used permanent suture material, it could be that the suture is reacting or seeded with bacteria. Another possibility is that the parotid gland was injured and you have a sialocele that comes and goes. In-person evaluation would be the most appropriate next step to determine the cause. 
-Dr. P

Alan Gonzalez, MD, FACS · Answer

Hello Dear @Yottiyotta, thank you for your question. There are several possible causes, so an in-depth analysis must be conducted. Therefore, a range of analyses must be conducted in order to find the source of the problem. or more information and recommendations is best to consult with one or several board certified plastic surgeons. Best wishes! Alan Gonzalez MD, FACS

Brian K. Machida, MD, FACS · Answer

Your initial history of needing Keflex followed by Cipro, although not common, is certainly not unusual for a post op wound infection. For it to occur again 6 months later is unusual. At this point, I don’t have your complete history so there are some gaps which only your doctor can fill. First, was there a culture done this time? Second, do you work in a healthcare setting or have pets? People who contract MRSA from a hospital setting can catch it and it can persist in the fur of animals(but not for an extended time). Third, it could be a suture granuloma if there is a permanent suture in the area. Fourth, it could be an inflamed lymph node which is totally unrelated to your surgery. Best to see your doctor and if he doesn’t think it’s due to surgery, see a head and neck/ENT specialist.

Ronald J. Edelson, MD · Answer

There may be a buried suture that needs to be removed. I can understand trying to treat it conservatively fir a while but if it continues to recur the area may need to be opened and explored fir a buried suture.

Gilbert Lee, MD · Answer

Thank you for your questions. Recurrent infections in the same location can be caused by a number of things including a suture. I recommend making an appointment with the surgeon who did your case. They will know exactly how the surgery was done and can best address any concerns you may have. Good luck!

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