The recovery portion of your facelift journey may not be without some small or even big bumps in the road. It is a possibility that you may develop one or several lumps, bumps, or dimples under the skin of the operated regions of your face. They may appear in various shapes and sizes and can be hard or soft to the touch. A few days to a week after surgery, you might begin to notice these lumps, bumps, or dimples on your face and neck. They may appear earlier or later along the healing journey, but for a good number of women they usually show up about 4 to 7 days after the operation. These lumps, bumps, and dimples are a normal part of the post-operative period and are usually nothing to worry about. Some women experience them during the course of their healing, but the good news is that lumps and bumps are a temporary condition and these pestering formations go away in due time.
The lumps and dimples in your cheek and neck area may simply be parts of the dissolving sutures yet to dissolve. Some plastic surgeons use dissolving sutures to reattach the underlying muscles structures of your face. The small dimpling and bumps on your face and neck can appear wherever dissolvable sutures were used in your cheek and neck area, where your SMAS and platysmal muscles are located, respectively. Most women recount that the bumps and dimples from their sutures appeared in their cheek area where SMAS muscle work was done. It is possible not only to see the presence of the sutures underneath the skin but to also feel them by touching the skin above the sutures. There is no real treatment to get rid of these bumps and dimples, as they will disappear when the sutures dissolve. Remember that not everyone that has dissolving sutures will experience these effects, which can take as long as 2 to 4 months to completely dissolve. It is a simple waiting game and there really isn’t anything you should do to get rid of them except to be patient, as many women are told to do by their PS. How fast your sutures absorb completely depends on each individual’s body, but they will dissolve over time and the bumps and dimples will only be temporary fixtures on your face.
The sebaceous glands are glands in your skin that are responsible for keeping the skin moist and pliable by releasing a thick fatty secretion into your skin called sebum. Sebaceous cysts may develop in the form of lumps and bumps, when the sebaceous glands in your skin get blocked or clogged, forcing these liquids to collect and swell in walled pockets under the skin. This blockage is usually due to skin trauma during your facelift and this usually happens when tissue glue is used in the surgery to seal your incisions instead of sutures. Tissue glue can lead to a higher instance of sebaceous cysts because of the shortened and speedy healing in your tissue and incisions that the tissue glue provides, but can be traumatic to your skin and interfere with the normal secretion of the sebaceous glands.
Treatment for these cysts can be a bit intense and may require drainage by a needle or through a small incision, or may require a small surgery to properly remove the cyst. Antibiotics may also be prescribed to treat them if they become infected. The normal recommendation for these cysts, as many doctors tell their patients, is to leave them alone unless they become bothersome or infected, as they will disappear over time, sometimes spontaneously. Warm wet compresses may also be applied to help the cyst force out some of its contents. If you think a cyst is the cause of your lump, make sure that you inform your PS immediately so they can advise you on the proper action to take.
Lymph nodes are the part of the lymphatic system responsible for filtration. The purpose of the lymphatic system is mainly to remove excess fluid and waste from the tissues it serves. Lymph glands help your body fight infection because they trap and eliminate foreign particles and infectious agents from entering the blood stream, as well as produce white blood cells and antibodies to destroy infecting germs and poisons. The main regions in which the lymph nodes exist are the groin, armpits, and neck. Enlargement of lymph nodes is a common condition, and can occur even if infection is trivial or not apparent. Swollen lymph glands after surgery is normal and might be related to the anesthesia or to a minor infection, such as an abscess. There is no need to worry if you develop swollen glands, but if the glands stay swollen for more than a week, are red and tender, or if one or more glands get larger over a period of two to three weeks, be sure to notify your PS.
Yet another cause of lumps and bumps may be the body's own production of collagen, a compound responsible for repairing damaged skin tissue. During the healing journey following a facelift, collagen is being laid down in areas that were damaged during surgery. At times, this process can be uneven and lopsided on one side of the face or another, leaving a lumpy appearance in areas where collagen production is higher. Collagen 3 may also contribute to scar formation (we fully discuss all forms of scar formation in the Irregular Scarring tab of the Complications: During & After Room.), which may be another cause for lumps and bumps suddenly appearing during week 2, 3, or 4 of the healing journey.
Lumps, bumps, and dimpling may or may not be a part of your facelift healing journey as they are not as common a symptom as, say, bruising or swelling. However, if you do experience them, they are perfectly normal, temporary, and nothing to be alarmed about. Lumps, bumps, and other formations may appear either before or after the onset day, although a good number of women first notice lumps and bumps at about 4 to 7 days after their surgery. However, it is important not to mistake normal lumps and bumps from a hematoma, or other complications that closely resemble lumps and bumps, but require medical attention, especially if the lumps and bumps cause pain or are otherwise sensitive to the touch.
At this juncture of the healing journey, your lumpy appearance is probably bothering you and you may be wondering when and if the lumps will ever go away. A number of women say to be patient because it may take time for your "lump problems" to go away. The lumps can significantly diminish and disappear over anywhere from 4 to 8 weeks post-op, but may take a few months longer and sometimes as long as 6 months for some lumps to disappear completely. A good number of women notice that their lumps peak at four to six weeks, followed by a noticeable decrease in size. You may find they disappear fairly quickly, but it is also normal to see a more gradual change. Note that after a symptom peaks, it can decrease rapidly at first and then subside more slowly. If you feel bumps at four weeks, you might notice a significant improvement by Week 6 or 8, however they might not be completely gone until a month or two after that.
While it’s not uncommon to have some lumpiness after a facelift, there are several ways to speed up the healing process.
Kenalog is a steroid that can be safely injected directly into the lump with minimal discomfort. Tiny amounts can be effective with repeat treatments done every four to six weeks until the lump resolves.
Manual lymphatic drainage (MLD) is a painless, non-invasive “massage” that can unclog lymphatic vessels that drain the surgical tissues to expedite healing. One MLD treatment before surgery, followed by several treatments after surgery, can help reduce bruising and swelling as well as soften lumps and scars.
Our experts at Iranian Surgery say Ultherapy™ has been beneficial in treating certain residual areas of swelling and firmness after facelift surgery. Ultherapy™, a non-invasive ultrasound with minimal to no downtime, also stimulates collagen for additional tissue tightening and lifting. In doing so, Ultherapy™ can enhance the results of surgery as well as prolong those results.
When considering these various treatment options, it is important to seek out a qualified facial plastic surgeon who performs a high volume of facelifts and thoroughly understands the anatomy and physiology of facelift surgery. Identifying the proper cause of the lump or bump is a key step in recommending the proper course of treatment.
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For more information about the cost of Facelift surgery in Iran and to schedule an appointment in advance, you can contact Iranian Surgery consultants via WhatsApp number 0098 901 929 0946. This service is completely free.