Facelift Complications

Bleeding is the most common complication after a facelift procedure. In the published literature, the average risk of bleeding after a facelift is 3% (8% for patients who have high blood pressure or for men).

Having a little bit of blood oozing from your wounds is normal and expected. Serious bleeding is when you notice significant swelling under the skin to a point that your skin protrudes. If that happens, please let us know immediately.

The most common cause of bleeding is uncontrolled blood pressure. For that reason, we treat your blood pressure before, during and after the facelift. Prior to the surgery, we will give you medication to lower your blood pressure, and continue to keep it low during the time of the surgery. Following your facelift, we will provide you with more medication for blood pressure, if needed. We also prefer that you stay at our Hotel facility overnight, stay relaxed and comfortable to avoid raising your blood pressure.

Skin necrosis happens when the blood supply to the skin is compromised and some parts of the skin then lack proper oxygen and nutrient supply. The rate of this complication is 1% in sub-SMAS procedures, and 3.6% in skin-only facelifts.

Infection is a very rare complication after a facelift because the face is very well vascularized. There is no scientific evidence to support pre-treating patients with antibiotics to prevent an infection from taking place. If one does develop an infection, the treatment depends on the type of bacteria isolated. Infections around the ear may be related to a species called Pseudomonas aeruginosa, which is naturally found in the ear canal. These are treated with antibiotics, and sometimes require drainage of any collection that may be found.

Signs of an infection include the following: Your skin is red, hot, especially tender and there may be some pus visible.

If you think you may have an infection after a facelift, send us a photo of the area of concern before becoming overly concerned, as very often, little bit of redness is normal and does not represent an infection.

The incidence of a permanent facial nerve injury is less than 1 percent, although transient nerve dysfunction for the first few hours after a facelift is common due to the lingering effects of the local anesthetic used during the surgery.

Prolonged nerve dysfunction can be due to traction, use of the cautery (to stop bleeding), sutures, or nerve transection. In most of these situations, there is a spontaneous recovery which can take place at any time between 2 weeks and 4 months.

There is not much to do in this situation, aside from waiting for the facial nerve to regain its function. While waiting, use of an injection such as BOTOX to temporarily relax the other side of the face is used to create symmetry.

Abnormal scars are scars that are placed incorrectly, that are obvious or may be hypertrophic or keloid.

Improper scar placement can lead to obvious scars, distortion of the ear, and un-natural shifting of the hairline. Excessive tension can cause scar widening, loss of hair, loss of pigmentation, and the development of hypertrophic scars.