Lower face lift 6 weeks ago. I looked good at 3-4 weeks. Now the swelling has increased with hard lumps under my chin (Photo)

Question

Use head wrap most of the time and have been sleeping in a recliner all this time. Only med is Aleve, no bending or exercise, watch my diet. But I look worse NOW than I did a few weeks ago. PS checked for fluid with needle, negative, and said to be patient, don't use the head wrap anymore and get on with a normal life.. ? 1. Is it normal for the swelling and hardness to increase with time? 2. What is the best way to deal with the hard lumps.. hot or cold compresses with gentle massage?

Dilip D. Madnani, MD, FACS · Answer

I am not sure exactly what was done under your neck but suffice to say that you are in the early phases of healing and things can change over time. I don't have a specific reason for why the hardness has suddenly appeared but keep your follow ups with your surgeon and go from there.

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Thank you for your question and pictures. You are still in the early stages of healing therefore swelling and bruising will still be present under the skin.  Please follow your PS aftercare protocol, as all PS will differ.  Please return to see them for regular follow up appointments.  All The Best

Jason Emer, MD · Answer

It can take up to 6 months to have your final results with a face lift. Since you're concerned, I recommend following up with your Doctor for a formal evaluation. To improve final results, I recommend a combination approach with thermage/venus legacy to help improve any swelling. I recommend getting a formal consultation with an expert. Best, Dr. Emer

John Michael Thomassen, MD · Answer

This paired swelling under the mandible may represent the submandibular glands that are now more exposed since fat was removed from your neck.  A procedure to reduce their size may be necessary to correct this.  Going forward, gentle massage with warm compresses may help.

Danny Soares, MD · Answer

Thank you for this question, as this is not an uncommon concern. By the appearance of your neck in the photo, I can surmise that you had an anterior platysmal plication (anterior platysmaplasty). The technique is incredibly valuable in individuals with thicker necks and less favorable neck angles because it can maximize the appearance of the neck on profile. However, there are some drawbacks to the procedure, and the most common one is prolonged swelling in the submandibular compartment (which houses the submandibular glands), as well as scar tissue formation (which typically resolves after several months). For some reason, this area is more prone to subcutaneous scar tissue formation than any other part of the face or neck treated during a facelift. In addition, in individuals with moderate aging, the submandibular glands are also droopy, and tightening the anterior neck muscle can make that become more apparent, and the swelling within the submandibular gland compartment doesn't help either. Surgeons have designed techniques to improve fullness in this area (such as the Feldman technique), but the reality is that this can still happen and in most cases it will resolve, typically after several months. In my experience, injection of local steroids, such as triamcinolone (kenalog) can be incredibly valuable; massaging can help and is often recommended but I'm not too certain of its value. Compression garments are neither likely to work nor are they convenient to wear regularly. I recommend that you follow-up closely with your primary surgeon to discuss whether these options are appropriate in your case given the type of surgery that you may have had. Best of luck!

Robert E. Zaworski, MD (retired) · Answer

Your surgeon may want to start you with facial massages, if he has not already.  Every patient heals at a different rate, so don't compare yourself to others.  You are still in the early stages of healing therefore swelling and bruising will still be present under the skin.  Discuss your concerns with your surgeon.

Lower face lift 6 weeks ago. I looked good at 3-4 weeks. Now the swelling has increased with hard lumps under my chin (Photo)

Answers (6)

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