Persistent inflammation and intermittent swelling 6 months post facelift

Question

Hello, I had a full deep plane face/necklift in May, with seroma, infection, necrosis and am left with some pretty bad scarring. Not only along incisions but lumps of scar in my neck and face. My Dr. says to accept an move on. I still have a lot of pain an a feeling like inflammation and spasm like pain. I saw another PS, who quoted me 18000 to fix. Is there any way to help pain and healing non surgically? My face also gets puffy and swollen off and on and can feel hard ridges.

Ronald J. Edelson, MD · Answer

It sounds like your surgeon has no desire to help you. Also it would be helpful to see photos. You may be able to get a refund, even partial, to help pay for a revision

Mark McRae, MD · Answer

It is quite unfortunate to have persistent pain and swelling after facelift.

In terms of pain:

Pain is quite rare but will improve with non surgical modalities. Pain may not necessarily be improved by surgery and in some cases revision surgery can make pain syndromes worse.

If the pain can be localized to a very discrete location, you may have a neuroma and that can be improved either with therapy, or with surgery. Your surgeon will be able to help you determine that.

If you are one of the very rare cases after any surgery or trauma where a pain syndrome may be present, your best bet is to be referred to a pain management team that can help address your pain from multiple modalities. Some modalities may be invasive (such as injections and blocks), and others such as psychologists that can help you navigate and overcome pain.

Saint Joseph’s Hamilton has an incredible pain management team with a wealth of resources available to you.

Massage therapy may be helpful to desensitize and help the nerves adjust. Other modalities such as acupuncture and muscle stim systems have also been found helpful if you have this kind of condition in other areas of the body and so may benefit you also.

Unfortunately revision surgery may improve your appearance, but it may not be able to address your pain. However with the right help you should be able to make improvements over time.

Jacob Tower, MD · Answer

Hello, hope you are well. I'm sorry that you had a poor experience. You may eventually need a revision, but remember that every surgery the body endures is also physiological trauma. That's why we get swelling, bruising, inflammation etc after surgery. Even with a complicated recovery such as yours, with time the body will heal to point. However, 6 months in the lifespan of scars and healing is not mature. Intervening too soon can be an opportunity to worsen a situation before it has had enough time to stabilize. I agree with seeking non-surgical remedies for now (and likely for at least 6 more months), but it is hard to be more precise and give sound advice without seeing you in person. 
Best,Dr. Tower

Stephen Prendiville, MD · Answer

Based on your description, you have had a very complicated recovery.  It's not surprising that you have ongoing issues at this point.  Although it is impossible to say precisely what should be done without an examination, you most likely will require a revision.  However, I would suggest waiting at least 6 more months prior to proceeding

Mats Hagstrom, MD (license on probation) · Answer

From your description, it sounds like you’re complications were significant. Without seeing before and after pictures, we can’t really make much of an assessment.
I suggest scheduling in person second opinion consultations if you have concerns and needs support that you’re not obtaining from your current provider.
There really isn’t much we can do to help you based on the information provided.
Best,
Mats Hagstrom, MD

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