3.5 weeks ago I had a smas lift. Very severe tightness and discomfort. (photos)

I have severe bunching behind my ears which does not appear to be improving . I also have a deep line and swelling a bit like a rope or tube down one side of my neck shuck is very unsightly , I usually wear my hair up but 3.5 weeks on the scaring and lumps are just to noticeable. Do you think this is going to resolve? very unsure as it appears to be getting worse not better Thank you

Doctor Answers 8

Post facelift skin bunching

Hi - thanks for your question.  You are very early post op and skin bunching like you show in your pictures is likely to settle over the coming few weeks. I would advise regular massage with a good quality moisturiser.  If the bumps persist in several weeks time it may be you need a small revision procedure however at this stage it really is too early to say whether this will be necessary.

Good luck

Tightness after Facelift

Hi ~ What you are experiencing can be normal. The swelling and irregularities on the incisions will go down significantly with time. This is something to discuss with your surgeon but there is a very good chance this will resolve with time.

Michael Hromadka, MD
Kalispell Physician
5.0 out of 5 stars 4 reviews

Dont worry

4 weeks is no time for a facelift to settle. Many of the symptoms you describe will soften and fade over time. Even if things like the bunching persist, they are relatively easily addressed by a minor procedure under local anesthetic as an out patient so try and be patient and you will notice quite a change over the next few months. Hope that helpsAdam Goodwin

Tightness after SMAS lift

After a facelift, tightness is extremely common because both the sagging skin and underlying facial muscles have been re-positioned and tightened.  Because of this your facial movement may be difficult as you go through the healing process.  Ask your surgeon what course of action you should be taking if you are concerned or had additional questions about the overall appearance.  

Michael T. Somenek, MD
Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 29 reviews

Has your surgeon checked it lately?

3.5 weeks is still very early, so it is normal to still have some lumpiness and firmness.  However, your photos show a bulge of the neck below/behind the ear which could be a fluid collection (seroma).  If you surgeon hasn't checked it lately, make an appointment to have him/her look at it.  If it is a fluid collection, it might be possible to empty it with a needle.

Will need some time

This tightness and bunching will need some time to resolve.
Massage and time will help.
You may need some future "unfurling" of the tissues if they don't improve enough with time.

Swelling Following a facelift procedure

Hello, and thank you for your questions in your photos. Based upon your photos I do believe you still has some swelling in the postoperative period. I would recommend continued lymphatic type massage for this area. You may also want to follow up with your treating surgeon for some additional guidance. MAny of these problems will resolve if not he may consider a small revisional procedure approximately 6 months following the original procedure to try to improve your results. Discussed all of this with her treating physician. Best of luck.

John J. O'Brien, Jr., MD
Saint Petersburg Plastic Surgeon
5.0 out of 5 stars 25 reviews

SMAS lift - now tight and uncomfortable

Thank you for asking about your facelift.

  • You said you had a 'very small' SMAS lift but the scars are those of a standard face lift.
  • After a standard face and neck lift, the bunching and tightness if it occurs takes time to subside - 
  • It should be much much better 6 weeks after surgery.
  • If you think the problem is getting worse, see your surgeon for an exam.
Always see a Board Certified Plastic Surgeon.
Best wishes - Elizabeth Morgan MD PHD FACS

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.