Red Lines from Face Lift Sutures

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?

Doctor Answers 13

Red scars after a face lift

Two possibilities - both normal.

  1. tiny capillaries. They appear in young scars, usually fade in 6 months but can also be removed with a laser, such as ND YAG
  2. Thickening scar - from collagen protein. Treatment - time as excess protein is absorbed and occasionally steroid injections.

How to tell which you have? If the tiny red lines are completely flat, a capillary is more likely.

If it is a raised thick line you can feel, it's probably protein.

Do they need treatment? No. Normal wound healing usually removed them without your doing anything. Best wishes.

Red lines from sutures

Dissolvable sutures under the skin disappear over 4 months after surgery and can cause redness as the body reacts against them to dissolve them. These should all resolve in time. 

Your facelift incisions are on their way to maximal healing

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!

Pink scars are new scars

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.

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 56 reviews

Facelift Scarring

During wound maturation after surgery the incisions always look worse berfore they get better. The operative word (no pun intended) is you describe thin lines. If these red lines get raised, thicker, or tender see your surgeon because hypertrophic (enlarged) scars could be forming. Be observant, but don't panic. This is not likely and they would develop very slowly.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Cortisone injections can help

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.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Red lines at face lift incision is normal and will go away

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.

Philip Young, MD
Bellevue Facial Plastic Surgeon
3.9 out of 5 stars 64 reviews

Wound healing

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.

Robert W. Kessler, MD, FACS
Corona Del Mar Plastic Surgeon
4.9 out of 5 stars 121 reviews

Facelift - Red Lines from Face Lift Sutures

It could be fine but you should, of course, touch base with your plastic surgeon about this.  In the absence of fever, chills, sweats, swelling, drainage, etc., it probably represents a normal part of the healing process, and may be due to tension, local swelling or irritation from the sutures.  Your surgeon should be able to help sort this out.

I hope that this helps and good luck,

Dr. E

Redness Along Incisions

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.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

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.