8 months post op and still experiencing temple and jaw pain - Could suspension sutures be causing this?

Question

I had a macslift almost 8 months ago, immediately after surgery I had jaw pain and couldn’t open mouth for a week, whenever I would chew my masseter throbbed. Also I had pressure headaches in my temporal area and temporal scalp pain on the same side as my jaw tightness/ pain. Could the suspension sutures be causing this? Are they too tight or in the wrong position? Will this go away or how can it be fixed?

Ronald J. Edelson, MD · Answer

On physical exam if there is tenderness where those suspension sutures are, then they might be causing the pain. However I have never seen this situation

Mert Demirel, MD · Answer

At 8 months after a MACS lift, persistent temple pain, scalp tenderness, jaw tightness, and pain with chewing should be evaluated in person. Some tightness is expected early after surgery, but symptoms that continue this long deserve a careful exam.
Suspension sutures can sometimes contribute to discomfort if they are tight, irritating deeper tissues, or placed in a way that creates tension near the temple or cheek. However, they are not the only possible cause. TMJ irritation, masseter muscle spasm, nerve irritation, scar tissue, temporal nerve sensitivity, or altered bite/clenching after surgery can also cause similar symptoms.
The fact that you had difficulty opening your mouth and throbbing in the masseter early on suggests the jaw muscles or TMJ may be involved. Temple pressure and scalp pain on the same side can also occur from nerve irritation or muscle tension.
This may improve with time if it is nerve irritation or scar-related tightness, but at 8 months I would not simply wait without reassessment. Treatment may include physical therapy, TMJ evaluation, anti-inflammatory treatment, massage if appropriate, Botox to the masseter/temporalis in selected cases, or rarely suture release/removal if a specific suture is clearly causing the problem.
My advice would be to return to your surgeon and also consider a second opinion from a facial plastic surgeon familiar with MACS lift techniques. Ask specifically whether the suspension sutures can be felt or localized to the painful area, whether there is TMJ/masseter involvement, and whether imaging or ultrasound would help. Revision or suture release should only be considered if the pain source is clearly identified.

Serdar Bora Bayraktaroglu, MD · Answer

Yes, suspension sutures can cause this. A MACS-lift anchors heavy tension sutures in the temporal fascia. If these sutures are placed too tightly or intersect nerve branches and muscle fascia, they can trigger chronic temporal headaches, jaw tightness, and masseter throbbing. While internal fibrosis typically softens over time, eight months of persistent pain suggests ongoing mechanical or nerve irritation. Consider consulting your surgeon or an interventional pain specialist. Targeted botulinum toxin injections into the masseter and temporalis muscles can relieve spasms, or a minor revision can release the tight anchor point.

8 months post op and still experiencing temple and jaw pain - Could suspension sutures be causing this?

Answers (3)

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