Face lift/Vector lift 26 days ago. Wondering if some obvious flaws will resolve with time. (Photos)

Question

I have a fold of skin at my temple on the right side and a horizontal line with a ridge of thickness below it on the left side. My surgeon was annoyed and somewhat defensive when I expressed concern on my 2 week post op visit, saying he wasn't a novice and this would resolve with time. He also said if any revision was needed I would need to wait 5 to 6 months. I'm not seeing how time will change it. It looks the same at 26 days as it did 1 day post op. How concerned should I be or am I over reacting?

Callum Faris, MD · Answer

Thanks for the great question. The tissue excess should settle with time. There is a trade off between limiting the length of the scar up the hairline of the sideburn and the redraping of excess skin. The longer the scar the easier it is to redrape the skin and avoid bunching. A small degree of bunching is not bad thing as small amounts of bunching will almost always settle and your Surgeon has likely kept the length of the scar to a minimum . If there is too much bunching then it may not all settle. keep in regular contact with your Surgeon.

Sam Speron, MD, FACS · Answer

Thank you for your photos and I am sorry to hear you are having some concerns post op. It is unfortunate that you were made to feel that way with your surgeon when you were addressing your concerns. It is important to be able to communicate openly with your surgeon in regards to any concerns especially during your healing process. Everyone is different and healing times vary. If a revision is necessary you must be healed first, so waiting five to six months post op sounds reasonable. If in doubt, visit another Board Certified Plastic Surgeon for help.  Thank you for your questions and best wishes!

John Mesa, MD · Answer

The appearance of the face shortly after a facelift ( eg 26 days) could be worrisome to some patients: swelling, bruising, wrinkles, pink scars etc are usually common at this stage but improve as the healing happens. Patients with questions and concerns about their facelift healing process should follow up their plastic surgeons advice and be patient with the (sometimes slow) healing process.

Konstantin Vasyukevich, MD · Answer

Dear Lisa,Thank you for providing good photographs.  You are definitely over reacting.  It is not uncommon after a facelift to have minor skin irregularities around the incision line.  Most of the time these type of skin pleats go away without any further intervention.  Occasionally a minor surgical correction might be required.  I would not call it a revision, though.  It could be done under local anesthesia and should not take much longer than 15-20 minutes.  So, in the worse case scenario you would end up getting a small touch up procedure to correct these skin irregularities.  Best of luck,Dr. Konstantin

John Michael Thomassen, MD · Answer

This will likely not improve much and I would recommend you revise it.  The incision would need to be extended up along your hairline further to take up the gathered skin.

Andrew Campbell, MD · Answer

The good news is that both the folds and ridge should improve over the next couple months. I am concerned whether the right sided folds will completely resolve though. I'd recommend massage at this time. It should be pretty easy to correct if massage doesn't make it go away. Even though your surgeon may seem annoyed, discuss your concerns and continue to follow up with them.Andrew Campbell, M.D.Facial Rejuvenation Specialist

Brian K. Machida, MD, FACS · Answer

This will improve with time. It might need a revision at 6 months. Continue with massage and follow with your doctor.

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. Sorry to hear you are not happy with the outcome and I can appreciate your concern. I think this outcome is a result of your surgeon trying too hard to keep the incision short and bunch up too much skin. Likely the incision needs to be extended so that the skin redundancy can be adequately addressed. Sometimes "minimally invasive" is not always the right answer. That being said, I would agree with your surgeon that this will likely settle and improve with time. I would recommend you consider some massage and scar management in the area to see if you can help the area settle. I would also agree that immediate re-operation is not the right answer. It is advisable to wait several months to see how things are going to settle before diving back into surgery. Try to have an honest and open conversation with your surgeon going forward and hope he chooses to respond more appropriately in the future. Hope this helps!

Christine Rodgers, MD · Answer

HI Lisa,  It does take some time for the swelling and fullness to go down after a facelift. Did you also have fat injections ? This will usually increase recovery time as well. It is true that a surgical revision should not be done right away, so 5-6 months is not out of line to wait this amount of time; however, it is difficult  when one has to go back to work very soon and the wrinkles are quite noticeable. Wait another 2 weeks and then talk again with your surgeon if the same amount of skin/swelling is still showing. If you had fat injections, you might ask him if it is acceptable to massage the area. Please discuss with your surgeon first, however,Best,Dr. Christine Rodgers

Beth Collins, MD · Answer

Your surgeon had the wrong reaction...perhaps he was having a bad day, we are all human. Next time, expect a different reaction....you only get the "bad day" excuse once in a while. Having said that you need to demand from him proper monitoring and a revision if needed. In general, I agree with most of the answers here that this will flatten in time, but the underlying problem is that the redundancy in the skin was not completely smoothed because I think he was trying to limit the extent of the incision. Because of this, it looks like the skin was not redraped smoothly. Yes, it will smooth in time, but it will take a long time and you are the one who has to live with it. Usually, I do not advise revision surgery for several months after surgery because the inflammation tends to complicate things and make the tissue behave differently (it tends to be stiff and bleeds easily if too close to the initial operation). But if you were my patient and you were very unhappy with the degree of puckering, I would consider an early revision here. (meaning after about 6 weeks) I am a surgeon so I get it that most things like this will work themselves out, but as a woman, I wouldn't want to have to wait six months with this. I would talk to your surgeon again.....if he isn't a novice, he should be able to help you!!

Face lift/Vector lift 26 days ago. Wondering if some obvious flaws will resolve with time. (Photos)

Answers (16)

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