Hard Swollen Mass Under New Jawline 1 Month After Facelift/Necklift? (photo)

   While seroma can recur, drainage and compression usually cause resolution after one or two aspirations.  If there is concern for salivary output, close followup with Botox and antisialogogues may be considered.  Kenneth Hughes, MD Los Angeles, CA

Thank you for your question for sharing your concerns with us. Repeated accumulation of fluid under the jawline can be a persistent seroma, but can also be a salivary gland leak.  I would recommend that you continue to get this drained and possibly insert a small drain tube if needed.  Medications can also help decrease the amount of saliva production and may help while this resolves.  I would make sure that you continue to follow up with your plastic surgeon during this period of time.

It is probably a little seroma but if it keeps returning I would start to think that it might be a salivary fistula. Keep up with your surgeon and I'm sure you will be fine.

You probably have a seroma or salivary fistula.  Both conditions resolve over time.  The salivary fistula can take weeks sometimes.  Your doctor may prescribe Robinul, which dries up your saliva temporarily.  It is frustrating, but I have never seen a case that has not resolved with time.  Good luck.

If the seroma in the neck after your facelift keeps recurring, it just might be a fistula to the salivary gland. They do resolve with repeat drainage, so stay in touch with your surgeon.

From your written description I think it is either a seroma reoccurring or a submandibular gland injury. Continual drainage with direct ultrasonic therapy can help correct. But if glandular issue I might try Botox injections. Now for the posted photos it appears as a irregular neck dissection or neck lipo. Please inform. 

you may have a seroma (collection of serous fluid) or possibly a salivary gland leak.  Recurrent aspiration of a seroma should hopefully lead to its resolution.  The use of a compression dressing over this area may help as well if possible.  If you have a salivary gland leak, the uses of some medications like those used by the anesthesiologists that help reduce saliva production may be of benefit.  You should discuss the options with your surgeon or seek a second opinion from another board certified plastic surgeon for reassurance.

Depending upon the location at the jawline, it may be a seroma or a salivary gland leak. If it is at the jaw angle area near or under the ear, it may be a parotid gland leak. If it is in front of the ear along the jawline closer to the mouth, then it is undoubtably a seroma. The fluid can be tested to answer that question definitely but it is probably not needed based on its location. A seroma will eventually resolve itself with repeated aspirations as needed. A parotid gland leak usually will also but may require other methods, occasionally surgical, to make it stop. 

According to your description and timing, I would say this is most likely a seroma.  Seromas occur when the skin is dissected away from the underlying soft tissue creating a 'dead space'.  The treatment is to monitor for infection, drain, and compress the area.  The goal is to have the skin adhere to the soft tissue.  It is not uncommon for a seroma to be drained multiple times before this happens.

What you are describing sounds like a seroma. The area may need to be opened a bit wider and then drained. Continue to followup diligently with your plastic surgeon.