I had a SMAS facelift almostexactly one year ago. I still have the sensation that my ears are being pulled down from the inside. I feel extreme discomfort and tightness along my jawline, under my chin and around the ears. I have brought this up with my surgeon and he claims to have no idea what this might be and offered to refer me to a pain clinic. Can someone please explain to me what may have caused this and what, if any, imaging or scan can be done to prove that damage was done? I seriously feel like I have been in chronic pain for the past year. I feel this tightness and pain every single moment of every day and I’m worried that this is irreversible and that the surgeon did irreparable harm. Please help!
Answer: Persistent Tightness and Pain After SMAS Facelift – Causes and Solutions Hello, First of all, I understand that you are going through a difficult time due to the discomfort and persistent pain you have been experiencing. After a SMAS facelift, some patients may feel tightness and discomfort, especially in the early healing stages. However, if these symptoms persist for a year, further evaluation is necessary. Possible Causes:Nerve Sensitivity or Damage: The nerves may have been affected during surgery, leading to prolonged discomfort.Some patients experience nerve irritation or compression, which can cause persistent tension and pain.Tissue Tightness and Scarring: Scar tissue formation and fibrosis can lead to a feeling of tightness or pulling in the skin.If the SMAS layer was tightened excessively, it could result in prolonged discomfort.Lymphatic Drainage Issues: Changes in lymph circulation after surgery may cause swelling, tightness, and discomfort in the affected areas.Muscle or Fascia Tension: Since the SMAS facelift involves repositioning the facial muscles and fascia, excessive tension can sometimes persist.What Can Be Done?✔ Imaging Tests: MRI or ultrasound can provide insights into the condition of soft tissues and nerves. If nerve damage is suspected, an EMG (electromyography) test may also be helpful.✔ Alternative Treatment Options: If the issue is nerve-related, nerve block treatments, physical therapy, or botulinum toxin injections may provide relief.✔ Consult Another Specialist: Seeking a second opinion from a plastic surgeon or neurologist can help determine the cause and possible solutions. I understand how challenging this situation is, and I believe your pain should be taken seriously. I recommend consulting with a specialist for a detailed evaluation and treatment plan. Wishing you a smooth recovery.
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Answer: Persistent Tightness and Pain After SMAS Facelift – Causes and Solutions Hello, First of all, I understand that you are going through a difficult time due to the discomfort and persistent pain you have been experiencing. After a SMAS facelift, some patients may feel tightness and discomfort, especially in the early healing stages. However, if these symptoms persist for a year, further evaluation is necessary. Possible Causes:Nerve Sensitivity or Damage: The nerves may have been affected during surgery, leading to prolonged discomfort.Some patients experience nerve irritation or compression, which can cause persistent tension and pain.Tissue Tightness and Scarring: Scar tissue formation and fibrosis can lead to a feeling of tightness or pulling in the skin.If the SMAS layer was tightened excessively, it could result in prolonged discomfort.Lymphatic Drainage Issues: Changes in lymph circulation after surgery may cause swelling, tightness, and discomfort in the affected areas.Muscle or Fascia Tension: Since the SMAS facelift involves repositioning the facial muscles and fascia, excessive tension can sometimes persist.What Can Be Done?✔ Imaging Tests: MRI or ultrasound can provide insights into the condition of soft tissues and nerves. If nerve damage is suspected, an EMG (electromyography) test may also be helpful.✔ Alternative Treatment Options: If the issue is nerve-related, nerve block treatments, physical therapy, or botulinum toxin injections may provide relief.✔ Consult Another Specialist: Seeking a second opinion from a plastic surgeon or neurologist can help determine the cause and possible solutions. I understand how challenging this situation is, and I believe your pain should be taken seriously. I recommend consulting with a specialist for a detailed evaluation and treatment plan. Wishing you a smooth recovery.
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Answer: Facelift - SMAS Not sure what is causing that however some surgeons use permanent sutures- I personally do not. Review the operative report with your surgeon to see if that could be the cause. For treatment, consider subcision and discontinous undermining with blunt instrumentation over the right areas. The "sliding browlift" uses this technique for a forehead lift technique that loosens the skin from the underlying muscle. Best Wishes with this issue.
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Answer: Facelift - SMAS Not sure what is causing that however some surgeons use permanent sutures- I personally do not. Review the operative report with your surgeon to see if that could be the cause. For treatment, consider subcision and discontinous undermining with blunt instrumentation over the right areas. The "sliding browlift" uses this technique for a forehead lift technique that loosens the skin from the underlying muscle. Best Wishes with this issue.
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April 16, 2025
Answer: Feeling tight after a facelift Hi,I am so sorry you are dealing with this. I have heard of this sensation from a few patients. The entire goal of a facelift is to lift and pull some of the deeper tissues and muscles tighter. This is especially true around your ears. 100% of my patients complain of a tight feeling after surgery that usually subsides in a few months. Rarely patients have complained about a similar tight feeling at 1 year after surgery. I have injected some botox in the tight areas to release some muscle tension and this had worked very well. Also massaging the area can be very helpful. I don't think any irreparable harm has been done and I would try these treatments. Time will also help. Wish you the best,Matthew Tamplen MD
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April 16, 2025
Answer: Feeling tight after a facelift Hi,I am so sorry you are dealing with this. I have heard of this sensation from a few patients. The entire goal of a facelift is to lift and pull some of the deeper tissues and muscles tighter. This is especially true around your ears. 100% of my patients complain of a tight feeling after surgery that usually subsides in a few months. Rarely patients have complained about a similar tight feeling at 1 year after surgery. I have injected some botox in the tight areas to release some muscle tension and this had worked very well. Also massaging the area can be very helpful. I don't think any irreparable harm has been done and I would try these treatments. Time will also help. Wish you the best,Matthew Tamplen MD
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March 17, 2025
Answer: Pulling scar tissue It's hard to answer without pictures or seeing you in some way. I'd consider a steroid injection into the tight areas to loosen tight scars.
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March 17, 2025
Answer: Pulling scar tissue It's hard to answer without pictures or seeing you in some way. I'd consider a steroid injection into the tight areas to loosen tight scars.
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