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

   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

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.

Thank you for your question. What you are experiencing sounds like typical postoperative swelling.  In general, 6wks is very early in the wound healing process.  These "lumps" can happen even when the incisions are not reopened.  The space below the skin is very limited, so any swelling or fluid deposits will be noticeable externally either by sight or feel.  These lumps will typically resolve over the first 8-12 weeks postoperatively. Best of luck and please call your plastic surgeon who will certainly ease your concerns.

I would wait for about 4-6 months to make any final judgements on the results of your facelift.  However, if you have any concerns in the meantime, make sure you go back to your plastic surgeon.

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

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.

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.  

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.

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.  

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.