Should I Worry SMAS Facelift (Short-scar) Had to Be Reopened During Surgery? (photo)

After being closed, my cheeks started bleeding (while I was having my eyes done) and both were reopened and suctioned. That was six weeks ago, and I'm experiencing increasing lumpiness (mostly small bumps under the skin)and have had slight indentations on each cheek since the surgery that have not gone away. Does this sound typical or more like aggravations from the reopening; in other words, should I be worried?

Doctor Answers 12

Hematoma after Facelift Surgery

While rare, hematomas (bleeding under the skin) can occur after a facelift. In order to treat them the incisions do need to be opened (ideally as little as possible) and then the incisions need to be re-sutured.

This can result in some lumps and bumps but the overall outcome of your surgery should not be hindered at all.

I would give yourself 3 months to let these areas go away.

Take care,

Dr. J

New York Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Lumps after 6 Weeks Following Facelift

   Lumps can persist for months as these can be little pockets of swelling, areas of suture, or underlying remodeling.  Hematomas sometimes occur, and evacuation is the treatment.  I am not sure that looking at your 6 week results that I would have been able to guess that you had a large hematoma evacuation.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Lumps after facelift

Its too early to worry. At six weeks, your face is still healing, both along the incision line, and under the skin. Your surgeon did the right thing when he re-opened the incisions to evacuate the hematoma and stop the bleeding. There shouldnt be any complication from having to re-open you. I would give it at least 6 months to fully asses the "final" outcome. If you have irregularities at that point, discuss it with your surgeon to see if there is any treatment to improve it.

Paul Wigoda, MD
Fort Lauderdale Plastic Surgeon
5.0 out of 5 stars 29 reviews

Hematoma and SMAS Facelift

Opening the incisions and evacuation of the hematomas and stopping any bleeding was absolutely the appropriate care during your procedure.  The small lumps under the skin are more likely related to the surgery and hematoma rather than having to reopen the incisions.  These irregularities should improve with time.  Continue to follow up with your plastic surgeon.  

Michael Sundine, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 18 reviews

Significant Hematoma after face lift should be addresses ASAP

Still too early to tell. Your surgeon did the right thing by reopening your incisions and removing any blood clots (hematoma). In this case 6 wks is a bit too early to determine final results. There many be traces of blood that still have to resolve naturally, and more swelling on that side. If there is no improvement after 3-6 months, then it is worthwhile discussing with your plastic surgeon what he feels will be the result.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

Hematomas after SMAS Facelift

Whenever you have bleeding after a case is closed you must open the area back up suction the clots out and find the source of the bleeding and then cauterize those blood vessels. You then go back to suturing and closing the facelift Incisions. So most importantly was that your surgeon did go back in and stop the bleeding. Secondly the lumps you are seeing may just be inflammatory areas that should dissipate over time. I would go in and see your surgeon and discuss your questions and concerns and hopefully he/she will be able to give you some peace of mind! Best regards!

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 210 reviews

Lumps after bleeding in surgery

Although the majority of the blood that accumulated during the bleeding episode was cleaned out, there will be some inflammatory response in the body while it tries to digest the small amounts still there. With time and massage, that should all get better, but the skin might look a little lumpy for a while

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Should I Worry SMAS Facelift (Short-scar) Had to Be Reopened During Surgery?

It was certainly imperative for your surgeon to reopen your incisions if you had excess bleeding. A facelift requires lots of elevating of the skin and bleeding can occur. Facelifts without bleeding can be a little lumpy for several months because of the deep sutures and movement of tissues under the skin. I would wait several months before worrying, but why not visit your plastic surgeon for his opinion? I would expect this lumpiness will resolve with more time. As a matter of interest, before any future surgery, be sure to stay off of any aspirin products, Advil, Aleve, fish oil or Omega-3, vitamin E including products with vitamin E such as Slim Fast and multivitamins, and Garlic. This is a long list, but all of these cause difficulty with your blood clotting system, thus more bleeding. Good luck.

E. Ronald Finger, MD
Savannah Plastic Surgeon
4.8 out of 5 stars 81 reviews

Short Scar Facelift

It sounds like your surgeon did the right thing. Nobody wants to take a patient back to the OR but due to vomiting or high blood pressure in the immediate postoperative period, a hematoma can form and it is imperative that it be evacuated. The lumpiness is normal especially in facelifts that utilize a cranial suspensiion suture. This usually resolves. The reality is there is nothing to do for it now. I would suggest waiting 6 months and then revisiting the problem if there is no change.  

Jacob Freiman, MD, FACS
Miami Plastic Surgeon
4.4 out of 5 stars 271 reviews

Facelift healing process

Good question. it is definitely possible to still have swelling and some contour irregularity 6 weeks after a facelift. If you had a hematoma during the case that required re-opening and evacuation it is possible that this may cause a delay in the healing process. That being said, I would not anticipate that this would compromise your long term outcome. You pictures look great and I would expect that these irregularities will resolve with time.

Todd C. Miller, MD
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 34 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.