Is There Anything else to Do at Home for Possible Hematomas, Besides Massaging?

Question

I had a facelift 4 weeks ago and have a couple of lumps in the cheek area. Still have bruising, possible hematoma and both sides of my face, close to my ears feels very firm, thick, numb and I can see a somewhat line close to my jaw line. Doctor says it is bruising and did use a needle in a few areas to see if he could get fluid out but without success. Doctor said to keep massaging and I go back to the doctor in 1 month. How much should I massage daily and how much pressure should I use??

Ronald J. Edelson, MD · Answer

It is not unusual to have some lumps on the cheeks which will gradually resolve over time.  They should be checked periodically by your surgeon in case they liquefy and can be drawn off with a needle.   There is no special for,ups for massaging these, but ten minutes three time a day should be adequate.

Kurtis Martin, MD · Answer

Eventually a steroid injection may be necessary. Massage will help and you can be somewhat firm in your massage. This will resolve in 4-6 months.

Kenneth Hughes, MD · Answer

Residual lumps may respond to massage but time will be the best treatment.  Kenneth Hughes, MD Los Angeles, CA

Vincent N. Zubowicz, MD · Answer

Massage of the skin, particulary vigorous massage, will not help dissipate a hematoma. As a matter of fact, it can release histamine in the subjected tissues which will actually increase inflammation. Check with the surgeon and follow his instructions.

Stephen Prendiville, MD · Answer

Generally speaking, the likelihood of a hematoma at 4 weeks post procedure (in an area that has been unsuccessfully aspirated) is pretty low. It is totally normal to feel areas that are firm, slightly thickened, slightly bruised, and/or numb at 4 weeks after the procedure. I do not advocate aggressive massage, because it may accelerate the process of inflammation. I ask my patients to try a gentle fingertip (lymphatic massage), and allow for a tincture of time.Stay in close touch with your Surgeon, and remember that this will resolve over time.

Teanoosh Zadeh, MD, FRCSC · Answer

Sometimes it may happen that you have significant bruising following a facelift and quite normal for the skin to feel numb or even tense around the ears. These symptoms do improve over time, however unless there is a significant collection of blood, which would be unusual, I would refrain from aspirating with needles. With regards to massaging, regular massaging can help soften the areas of bruising.

Philip Young, MD · Answer

Pictures would really help me to give you more of an opinion. Hematomas if significant should be removed. You can do some suctioning early to improve this. But at 4 weeks I would have your doctor follow you more closely. Steroid injections done thoughtfully could be important as well as some careful application of pressure and massage.

Jonathan Berman, MD · Answer

It sounds to me like both you and your surgeon are doing exactly what is appropriate in the circumstances.  Unfortunately, bruising, swelling, numbness and yes, even hematoma, are all part of the postoperative potentials, and must be dealt with on an individual basis.  Rarely have I had a facelift patient who did not have at least minimal swelling, bruising and numbness, and of course it would be ideal if no one ever had a hematoma. 

	Jonathan Ross Berman, M.D. , F.A.C.S.

Robert L. Kraft, MD, FACS · Answer

Bruising takes time to resolve.  It is to be expected and massage can hinder, rather than speed, the healing.   Keep on touch with your plastic surgeon, avoid the sun, excessive alcohol, cigarette smoking, etc and give it time. The numbness may persist for several months until it gradually abates.

Richard Ellenbogen, MD (retired) · Answer

We used to call these silver dollar hematomas . They are the size of a silver dollar but they are the late scar resulting fom under skin bleeding. I recommend dilute kenalog onjection 2.5 mg in 1 cc of fluidevery 3 weeks. I recommend pressure with cold spoons (spoons in the freezer for an hour) four times a day for 10 minutes.I have used endermology and ultrasound and both help/ The real treatment is tincture of time

Is There Anything else to Do at Home for Possible Hematomas, Besides Massaging?

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