Ropey Firmness from Ear to Adam's Apple 10 Days Following Necklift and Lower Face Lift. Is This Normal? (photo)

Question

I had a lower face and neck lift 10 days ago. My bruising and swelling are resolving fairly well. I am still quite numb, especially around the ears. My main concern are 3 areas of swelling: 2 ropey firm cords from ear to throat, and a swelling at my Adam's apple region. I have been doing some massage but it isn't helping. Should I be worried about fluid collections or fibrosis? My JP drains were removed around 36 hours post op. I see my PS in 2 days for my 2-week post op appt.

Dana Goldberg, MD · Answer

Swelling and firmness after facelift can represent bleeding under the skin, fluid collections, sutures, or inflammation. Most of these changes will resolve on their own after surgery, but it can take months for this to happen. From the pictures, it looks like the areas you are concerned about might be related to bruising, but it's hard to say for sure. Some doctors use ultrasound to help speed healing, but do not start this without discussing it with your surgeon. Best of luck!

Larry S. Nichter, MD, MS, FACS · Answer

The good news is that this is probably normal and will resolve with time. The linear ridge of swelling can be caused by the drain, serum (seroma), blood (hematoma) or an edema ridge as fluids run downhill especially if your chin was in a down position during the early healing process which traps edema in a roll of skin. Often lymphatic massage, ultrasound, low salt diet among other recommendations may be helpful for many. Regular follow up with your plastic surgeon is indicated. Should it not resolve in the next several weeks, use of dilute steroid mixed with 5FU is often very helpful in my experience to speed the resolution, but this will take some time to completely resolve which is the case most often in my experience.

Vincent N. Zubowicz, MD · Answer

From the photograph it appears that the strip occupied by the Jackson Pratt drain became filled with fluid after its removal. This can be aspirated which will resolve the problem. Even untreated it will eventually dissipate.

Frank P. Fechner, MD · Answer

After studying your photograph, I think you are healing within expected limits of normal. What you are describing (firmness, numbness, localized areas of swelling etc.) are expected and should improve with time. Your face lift surgeon will most likely confirm your appropriate progress.

Kenneth Hughes, MD · Answer

The firmness should improve with time. Are the areas of concern consistent with the placement of the drains? Any residual fluid should be drained, although your areas appear of little concern for significant fluid collection. Kenneth Hughes, MD Los Angeles, CA

Houtan Chaboki, MD · Answer

A certain degree of skin or tissue firmness is expected after cosmetic facial surgery. The firmness gradually softens with time, as does the swelling and bruising. At some point after facelift surgery, some plastic surgeons will recommend massage, warm or cold compress, or gentle neck exercises. Only your facelift surgeon can best answer your question. Speak with him/her any concerns you have.

	 

	Dr. Chaboki

Darryl J. Blinski, MD · Answer

Appears as a good early result. But you might benefit from external ultrasound therapy. Discuss with your surgeon.

Steven Wallach, MD · Answer

Some swelling and firmness in the neck is normal post-op especillay as your activity level increases.  it will get better with time but definitely discuss this with your surgeon.

Francis (Frank) William Rieger, MD (retired) · Answer

You appear to have a predictable postsurgery facial swelling.  The overall effect seems to be in good shape.  Just give it more time.  Certainly you can consider ultrasonic external treatmen, or even use simple massaing manually over this area, carefully applied certainly.

	 

	Good luck to you.

	 

	Frank Rieger M.D.

Sheldon S. Kabaker, MD FACS (retired) · Answer

It looks like some blood accumulated around the drains. Perhaps the drains lost suction . These lumpy areas should resolve with time.

Ropey Firmness from Ear to Adam's Apple 10 Days Following Necklift and Lower Face Lift. Is This Normal? (photo)

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