Red Lines from Face Lift Sutures

Question

I had a Face Lift 45 days ago. In the past week, I have been seeing thin red lines developing from the suture areas behind my ears and scalp incisions.  What and why is this happening?  Will they go away?

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Surgical incisions undergo several phases of healing before they mature and become less visible. By your description it sounds like your surgical incisions are taking the usual course toward maximal healing. The redness that incisions develop is just part of a healing phase where the process is very active with the development of new blood vessels that delivery healing cells to the area. Once the healing cells have been delivered and mature collagen and fibrous tissue have been placed by these cells the blood vessels regress to a normal level. What that means is that the incision will loose its red color and fade into the surrounding skin to become less visible. This process may take up to a year to complete. You should see study improvement month to month.
Hopefully this was helpful. Enjoy the new you!

Jed H. Horowitz, MD, FACS · Answer

The #healing process in general can take up to one month for the majority of swelling to subside, incisions to close, sutures to come out, and for bruising to completely go away. #Recovery time from a #facelift varies from person to person, but patients can generally expect to be presentable within three weeks from surgery. Patients should expect swelling, bruising, and discoloration of the skin during this phase of recovery (swelling normally goes down after 48 hours; most bruising will go away within two weeks). Some degree of firmness or #lumpiness under the skin is normal after surgery and will resolve with time. Local #massage will speed resolution of this problem, which normally takes 2-4 months to disappear completely.The marks from a facelift can easily hidden with “camouflage” make-up which you can learn how to apply.The scars from a facelift mature within six to twelve months from the surgery date. It is during this time that the rejuvenating effects of the facelift will become apparent and the real result will be seen. If you have certain concerns about the procedures and #healing process, it is recommended to call your board-certified surgeon or their medical staff and discuss those #concerns.

Anil R. Shah, MD · Answer

Scars undergo various changes until they are completely healed, one year after surgery. Early on, it is normal for a small amount of redness to appear. Ideally, your scars will convert to a thin white line which is difficult to see.

John M. Hilinski, MD · Answer

What you describe is a fairly normal occurrence following facelift surgery. At 7-8 weeks there is a moderate amount of wound healing ongoing. In fact, there is quite a bit of collagen remodeling taking place along the incision lines. What you see in terms of a fine red line represents to some degree preferential blood flow to these areas as they continue to heal. As long as the redness remains confined to a fine line you will see progressive improvement with time.

	If, however, the fine line turns into a wider scar with more redness and hardening, you should consult your surgeon. This might be indicative of hypertrophic or keloid scarring where too much collagen is laid down by your body during the attempted healing process. This can usually be managed with a series of steroid injections.

William Portuese, MD · Answer

The red lines that may be occurring can be hypertrophic scars occurring on the actual incision sites. These, when they occur, need to be addressed immediately by placing cortisone injections into them to smooth and flatten them down. They will eventually settle down and go away, but the cortisone shots will start to make them shrink.

Robert W. Kessler, MD, FACS · Answer

The body heals incisions by increasing blood supply to the area.This brings oxygen nutrients and all the cells active in healing the surgical site. Generally speaking the incision itself may remain red for a few months until the process is resolved. Complete healing and remodeling continue up to 1 year. You are still in a very early stage of healing.
When you mention red lines developing from the suture area behind the ear a few things come to mind. Sutures are considered foreign bodies and the body will have a reaction to them. The reaction to absorbable sutures is more dramatic and can cause localized inflammation. Tension across a healing wound may also appear this way as a scar widens to minimize the tension across it. Localized infection in the suture line may also present this way.
I would recommend returning to your surgeon for a follow up and express your concerns. There are things that can be done to improve the appearance of scars in the early post operative period. If this is just the normal increase in blood supply to the area after surgery all that is needed is your surgeons reassurance.

Steven Wallach, MD · Answer

At about 7 weeks it is common for the incisions to appear a bit red as they heal.  Usually this improves with time.

Jason B. Diamond, MD, FACS · Answer

The redness you are seeing can be caused by the bodies reaction against the sutures which is what causes them to dissolve.  This is a normal reaction and should resolve shortly.

Lavinia K. Chong, MD · Answer

If the scars appear to be fine lined, flat, narrow but red-pink, the color is a consequence of their newness. All scars undergo a process of maturation and remodeling, which occurs until they are flat, narrow, white lines. Scar maturation also involves softening and flattening of the scars; it typically requires a minimum of 90 days, during which time the "inflammatory process" or pinkness will decrease, progressively. Since your surgery was only 45 days ago, it is likely that your scars will improve, just be patient. Good luck.

Philip Young, MD · Answer

Red lines along the incision line is a normal process that happens after a procedure that creates an incision. The incision is the area that is exposed to the environment the most and ultimately is the area that undergoes the most inflammation. This obviously will lead to more of a reaction that creates more blood supply that leads to the redness in the area. There are many ways to improve this. 
After the incisions heal, any silicone gel based scar gel can be used on these incisions to improve the appearance of the scar. If the incision is particularly red, one can consider a topical steroid to help with the inflammation that is creating the redness.
Another option that might be more forward thinking would be to employ lasers and IPL along the incision to decrease the vascularity although you have to go to someone with experience with this. The redness will eventually go away and makeup can usually be applied after the first 2 weeks.

Red Lines from Face Lift Sutures

Answers (13)

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