CONDITION / FACE

Complications after a facelift.

Complications after a facelift are problems that go beyond normal healing after a facelift: a hematoma, dead skin, nerve damage, rough scarring, or a displaced earlobe. They are treated even when the operation was performed in another clinic.

Discuss your case How it is treated in the clinic ↓

CONCEPTUAL VISUALIZATION

OVERVIEW

What it is: Problems after a facelift that go beyond normal healing.
How common: Serious complications requiring emergency care or reoperation were 1.8% in a cohort of 11,300 patients.
Most often: Hematoma, that is, accumulation of blood under the skin; then - failed scars and temporary nerve damage.
Who treats it: A plastic surgeon who performs reconstructive and repeat operations.

01 / WHAT IS IT

What is
facelift complications.

A facelift, or face lift, is an operation in which the skin of the lower part of the face and neck is tightened and stitched in a new position. The incisions are made on the temples, in front of the ear, under the lobe and behind the ear.

Some of the changes after surgery are normal healing. According to the NHS, facial swelling and numbness can last for weeks or months, bruising for at least 2 weeks and the final appearance taking 6-9 months.

A complication is something that goes beyond these: hematoma, dead skin, infection, nerve damage, rough scarring, hair loss around the scars, displaced earlobe. In general, they happen infrequently.

If the first operation was performed in another clinic, this is not an obstacle: the doctor evaluates what is available now and draws up a treatment plan.

This is general information. The doctor will tell you what will suit you after the examination.

02 / SIGNS

What can
go wrong

Symptoms depend on the type of complication. Here are the ones that are contacted most often.

Hematoma

Blood accumulates under the skin: the face or neck area swells, hardens and hurts.

Dying skin

The skin area darkens and dies, the wound does not heal for a long time.

Skin necrosis after surgery

Numbness and weakness of facial expressions

The skin of the face or ear does not feel touch, the corner of the mouth or eyebrows move worse than before the operation.

Paralysis of the facial nerve

Rough scars

Scars near the ear or on the temples are wide, thick, red, or tighten the skin.

Scars after operations on the face

"Stuck" earlobe

The lobe was pulled down and forward, and it seemed to be glued to the cheek. This deformity is called "pixie ear".

hair

The growth line on the temples or sideburns has risen, the hair has thinned near the scars.

03 / REASONS

Why do they arise?
complications

Part of the risks depends on the person himself, part on the technique of the operation and how the first days after it passed.

Pressure and medicine

High blood pressure after surgery, blood-thinning medications, aspirin, or anti-inflammatory pain relievers increase the risk of hematoma.

Male gender

Hematoma occurs more often in men: in a cohort of 11,300 patients, the risk was 3.9 times higher.

Smoking

Smoking damages the small vessels of the skin. In a study of 83 facelifts, dead skin was more common in smokers who did not quit after surgery.

Untreated hematoma

Accumulation of blood under the skin can cause long-term swelling of the face and death of the skin.

Tissue tension

When the skin is pulled down and forward, the earlobe shifts and "sticks" to the cheek.

Several operations at once

When a facelift is combined with other operations, there are more serious complications: in a cohort of 11,300 patients, up to 3.7% versus 1.5% after a single facelift.

04 / SEEK MEDICAL ADVICE

When to seek medical advice?

If the operation was a long time ago and you are concerned about scars, earlobes or the shape of the face, this is a planned situation, it usually does not require emergency care. If the complication has just appeared, and there are no signs listed for 103, first contact the surgeon who operated on you. Sudden facial contortion is not the same as facial weakness immediately after surgery: it can be a sign of a stroke, so call 103.

103 immediately if:

it became difficult to breathe or sudden shortness of breath appeared;
chest pain;
the area of surgery on the face or neck quickly swells and tenses;
heavy bleeding from the wound that does not stop;
the face suddenly turned to one side;
sudden weakness or numbness of an arm or leg on one side;
speech was suddenly disrupted;
confusion of consciousness;
very frequent breathing;
the skin on the body has become bluish, pale or spotted;
a rash that does not go away when pressed.

When to the surgeon:

On the same day: to the surgeon who operated, or if this is not possible - to any surgeon, if the skin around the wound darkens, turns blue or black, the wound is red, hot, pus flows from it, the stitches have come apart, the temperature has risen to 38 °C and above, or one leg hurts and is swollen. In the coming days: numbness or weakness of facial expressions, which was noticed immediately after the operation and which does not increase, is most often a temporary damage to the nerve branch; tell the surgeon about it. Planned: scars, earlobes, hair, asymmetry — the final appearance takes 6–9 months, but you can see a doctor even earlier.

05 / DIAGNOSTICS

As defined,
what to treat

Conversation and documents
When, where and what kind of surgery was done, how the first weeks passed; statement and photo before the operation, if any.
Review
The surgeon evaluates the skin, scars, earlobes, hairline and facial muscle movements.
Sensitivity and facial expressions
If there is numbness or weakness, assess which area is affected and to what extent.
Examination as needed
Ultrasound to look for blood or fluid accumulation; tests if there are signs of infection.

06 / TREATMENT

How we treat
complications

Treatment depends on what exactly happened and how much time has passed. Some of the changes pass by themselves, some are treated without surgery, and repeated interventions are planned when the tissues have healed.

The first days and weeks

Acute complications.

Hematoma: Serious hematomas requiring emergency care or reoperation occurred in 1.1% of cases in a cohort of 11,300 patients. The growing hematoma is removed by the surgeon as soon as possible: without treatment, it can cause long-term swelling and death of the skin.
Infection: In the same cohort — 0.3%. The risk is higher if the facelift was combined with other operations or if the body mass index is 25 or higher.
Dying skin: Dead tissue is removed and the wound is cared for until it heals; the deep defect is covered with own tissues.

Nerves

Numbness and weakness of facial expressions.

How common: According to a meta-analysis of 67 studies (15,404 patients), motor nerves are damaged in 0.66% of cases, sensitive nerves in 0.39%; permanent damage — about 0.05%.
Recovery: In a systematic review, 70% of patients recovered completely within six months without surgery—with medication and physical therapy; 10% of violations remained.
If it does not pass: Deeper nerve damage may require nerve surgery or other methods. Long-term paralysis of the facial nerve is treated separately.

Scars, ear lobe, hair

Planned corrections after healing.

Rough scars: According to international recommendations, for hypertrophic scars and keloids, the best chance of success is given by a combination of several methods, among them laser. A wide scar can be excised and sewn up in a new way.
Earlobe: The "elf ear" deformity is found in about 5% of cases when the lobe is hemmed during a facelift. Many techniques are described for its correction.
hair: A raised growth line on the temples and thinning near the scars are known consequences of a facelift; what can be done, the doctor will say during the examination.

Repeat facelift

when: Repeated lifting is done due to an unsatisfactory result of the first operation or due to age-related changes many years later; on average — after 9–12 years.
Features: The tissues after the first operation are thinner and scarred, so the intervention is more difficult. According to the available data, the overall frequency of complications is comparable to the first operation, but temporary nerve damage occurred more often in some series — up to 11.9%.

07 / AT THE VALIKHNOVSKYI INSTITUTE

How
we treat it.

Complications after a facelift are treated at Dr. Valikhnovskyi's Institute of Surgery in the direction of "Treatment of complications of aesthetic operations" - in particular, when the first operation was performed in another clinic.

CLINIC SERVICE Treatment of complications of aesthetic operations Skin necrosis, dehisced wounds, capsular contracture, liposuction irregularities, and gross scarring. View service

What we do for this condition

Cleaning the wound and dressing — dead tissues are removed; small areas on the face often heal under dressings.
Vacuum therapy — a dressing with negative pressure diverts discharge from the wound and prepares it for closure.
Free flaps — if a deep defect remains after the removal of dead tissues, a complex of tissues (for example, from the thigh) is transplanted with suturing of vessels under a microscope.
Perforating flaps — a thin flap on one small vessel covers a defect on the face or neck with a fabric similar in color and thickness.
Excision of scars — a rough scar is cut out and stitched using another technique; hypertrophic and keloid scars are treated in combination.
Lipofilling — the patient's own fat is injected under the scar tissue.
Silicon and fractional laser — scar care from the first weeks and treatment of rough scars.
Tranexamic acid — a drug that reduces bleeding during repeated operations.

Rostislav Valikhnovskyi

Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovskyi Institute of Surgery.

About the doctor ORCID

How treatment works with us

Photo onlineSend a photo of the face now and, if available, a statement from the clinic where the facelift was performed.
ConsultationExamination of scars, skin, earlobes and facial expressions; if necessary - examination.
PlanWhat to treat now, and what to treat after healing, and in what sequence.
TreatmentDressings, vacuum therapy, excision of scars, flaps or lipofilling - depending on the complication.
RecoveryExaminations until complete healing; the final appearance of the scars is assessed not immediately, but after months.

Discuss your case Call

08 / QUESTIONS AND ANSWERS

Common
questions

Short answers. What is right for you, the doctor will tell you during the consultation.

Is it possible to be treated at your place if a facelift was done in another clinic?

Yes. The doctor assesses what is now and makes a plan. Take a statement from that clinic and a photo before the operation, if you have them.

Is a swollen and numb face a complication?

Not necessarily. According to the NHS, swelling and numbness after a facelift can last for weeks or months, and stiffness usually resolves within 6 weeks. If the swelling grows rapidly on one side, is tense and painful, it may be a hematoma: call 103, and then inform the surgeon who operated.

After the operation, the corner of the mouth dropped. Will facial expressions recover?

Most often yes. In a systematic review, 70% of patients recovered completely within six months without surgery; 10% of violations remained. How long to wait and whether treatment is necessary, the doctor will tell after the examination. If the face is crooked suddenly, and not immediately after the operation, call 103.

When can a scar or earlobe be corrected?

Usually after healing: the final look after a facelift takes 6-9 months. The doctor will tell you what to do and when during the examination.

Is it possible to do a repeat facelift?

Yes. It is more complicated, because the tissues are changed after the first operation, but according to the available data, the overall frequency of complications is comparable to the first operation; temporary nerve damage in separate series occurred more often.

Why did the hematoma appear?

High blood pressure, blood thinners, aspirin, and anti-inflammatory pain relievers increase the risk; hematoma occurs more often in men.

Does smoking affect healing?

Yes, smoking damages the small blood vessels of the skin. In one study, dead skin was more common in smokers who did not quit after surgery.

09 / SOURCES

Sources

15 sources · systematic reviews, cohorts, international guidelines and NHSshowCollapse

Preoperative Risk Factors and Complication Rates in Facelift: Analysis of 11,300 PatientsAesthetic Surgery Journal, 2016doi:10.1093/asj/sjv162 ↗
A Systematic Review of Rhytidectomy Complications and Prevention Methods: Evaluating the TrendsAnnals of Plastic Surgery, 2025doi:10.1097/SAP.0000000000004272 ↗
Facelift Surgery and Nerve Injury: A Systematic Review and Meta-AnalysisAesthetic Plastic Surgery, 2025doi:10.1007/s00266-025-04932-7 ↗
Management and outcomes of facial nerve injury following rhytidectomy: a systematic reviewMaxillofacial Plastic and Reconstructive Surgery, 2025doi:10.1186/s40902-025-00494-5 ↗
Evidence of Hematoma Prevention After FaceliftAesthetic Surgery Journal, 2024doi:10.1093/asj/sjad247 ↗
The prevention of haematoma following rhytidectomy: a review of 1078 consecutive faceliftsBritish Journal of Plastic Surgery, 2001doi:10.1054/bjps.2001.3623 ↗
Association between cutaneous occlusive vascular disease, cigarette smoking, and skin slough after rhytidectomyPlastic and Reconstructive Surgery, 1986doi:10.1097/00006534-198604000-00013 ↗
The pixie ear: How to prevent and correct it-a review of the literatureSurgery, 2024doi:10.1016/j.surg.2024.06.017 ↗
Challenges and complications in secondary rhytidectomies, a systematic reviewJPRAS Open, 2026doi:10.1016/j.jpra.2025.11.007 ↗
Revision Rhytidectomy: Pearls and PitfallsFacial Plastic Surgery, 2025doi:10.1055/a-2190-8558 ↗
Updated international clinical recommendations on scar management: part 2--algorithms for scar prevention and treatmentDermatologic Surgery, 2014pubmed.ncbi.nlm.nih.gov/25068544 ↗
Facelift (rhytidectomy)NHS, 2023nhs.uk/tests-and-treatments/cosmetic-procedures/cosmetic-surgery/facelift ↗
DVT (deep vein thrombosis)NHS, 2026nhs.uk/conditions/deep-vein-thrombosis-dvt ↗
Symptoms of a strokeNHS, 2024nhs.uk/conditions/stroke/symptoms ↗
SepsisNHS, 2026nhs.uk/conditions/sepsis ↗

The figures on the page are from these sources.

VALIKHNOVSKI SURGERY PARTNERS

Something went wrong
after a lift?

Send a photo of your face and a statement from the clinic where you were operated on. The doctor will tell you what can be fixed and when.

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