Is it normal to have a severe feeling of vice like tightness 5 weeks post op following a sonobello lift?

5 weeks post op of Sonobello Facelift. Having severe discomfort --vise like tightness which worsens as the day goes on. Motrin, narcotics, Arnicare, ice and heat do not relieve the discomfort.The skin on my face is not tight despite the tightness sensation. I still have jowls which go away when I pull the skin in front of my ear. Pain is less than week 1. When I addressed this with Jennifer PA who then discussed with Dr Fink, they just gave me a Rx for another narcotic. Any suggestions?

Doctor Answers 4

Make an appointment

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it's best to make an appointment to see your doctor to have your questions answered if you are not satisfied with the response. You are still very early in your post op course and tightness can still be felt. It is a good sign that the pain is decreasing.

Vicelike tightness

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  • Typically, a SMAS lift and a platysma (neck muscle) tightening procedure can result in a sensation of tightness in the throat from the platymaplasty and difficulty opening the mouth from the SMAS lift. This can get worse, before it gets better as the healing process is inflammatory in nature. However, this begins to diminish after six weeks. 
  • Loose skin after a lift is a bit of a problem in that nothing can be done for this for at least six months. Then, a skin only can be done to correct that problem.
  • At the six week mark, if you are still suffering, a short round of steroids may help expedite the resolution of persistent swelling. Heat and massage can help too, but the bottom line is tincture of time. All tightness goes away eventually. Some take while longer than others.

Robert H. Woods, MD
Scottsdale Facial Plastic Surgeon

What to Expect While Healing From a Facelift

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The healing process in general can take up to one month for the majority of swelling to subside, incisions to close, sutures to come out, and for bruising to completely go away. #Recovery time from a #facelift varies from person to person, but patients can generally expect to be presentable within three weeks from surgery. Patients should expect swelling, bruising, and discoloration of the skin during this phase of recovery (swelling normally goes down after 48 hours; most bruising will go away within two weeks). When the skin is separated from the underlying tissues during surgery, small sensory #nerves are cut. Varying degrees of numbness will be present after surgery and will improve gradually as the nerves reconnect to the skin. This process can take from 2-6 months for face, neck and cheeks, and to 9-12 months for the forehead and scalp. Muscle weakness may also be present around the mouth especially if liposuction is used. This typically recovers fully in the months after surgery. 

As the nerves regenerate, the itching, burning, tingling and shooting #sensations will occur. Ice, moisturizers and gentle #massaging are helpful during this phase of the #healing process. Frequently there is a tight feeling in the neck, jawline and cheek after a facelift. During surgery, not only the skin but the underlying muscles are tightened to create a better and longer lasting result. Additionally, the #swelling will move downward in the first week and the neck will feel even tighter. Do not be alarmed: the sensation will decrease during the first month. 

Some degree of firmness or lumpiness under the skin is normal after surgery and will resolve with time. Local #massage of the areas may accelerate the resolution of this problem, which normally takes 2-4 months to disappear completely.
The marks from a facelift can easily hidden with “camouflage” make-up which you can learn how to apply. The scars from a facelift mature within six to twelve months from the surgery date. It is during this time that the rejuvenating effects of the facelift will become apparent and the real result will be seen. If you have certain concerns about the procedures and #healing process, it is recommended to call your board-certified surgeon or their medical staff and discuss those #concerns.

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Lifestyle lift

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I personally worked for lifestyle lift and can not real any patient needing narcotics at 5 weeks. Your jowls should have been corrected with a facelift. You may want a second opinion. Most patients use narcotics for the first 3-5 days after a facelift.

William C. Rigano, MD
Dayton Plastic Surgeon

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.