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What Are Lumps, Bumps & Other Formations And Why Do They Happen?

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.

Lumps and bumps may occur for a number of different reasons, which could be why lumps and bumps may have vary in appearance between women who experience this symptom. One possible cause is the dissolving sutures under the skin. Some doctors use dissolving sutures, and when they reabsorb they can create a lumpy appearance. As a result, some women have actually been able to feel the sutures under the skin. It is also possible to see physical lumpiness in the cheek area, where it is common practice for surgeons to use dissolving sutures. A few veterans have also mentioned that the sutures temporarily caused small indentations on the sides of their face. These small indentations resembled lumps and dimples, but eventually disappeared. So if the lumpiness persists for some time, do not be alarmed, as it is normal for these sutures to take time before they fully dissolve and you may be able to both see and feel them for a couple months.

Cysts, which sometimes form during the post-op period, usually when the PS has used tissue glue to seal incisions, are another cause of lumps and bumps. Cysts are abnormal swellings or sacs that usually contain fluid. They usually appear pasty white, red (especially if they become infected) or skin tone color, but they can also have grayish blue tint, thanks to the fluid that they contain. Cysts may secrete a pasty or cheesy smelling fluid. When a sebaceous gland becomes blocked, as can occur after facelift surgery, oily fluids accumulate and a sebaceous cyst may form. If your lump seems to be filled with fluid, it may be a sebaceous cyst. Unless they become infected or painful, sebaceous cysts usually go away on their own. A few facelifters talked about sebaceous cyst as hard to the touch and having a "bluish gray" tint. The use of the glue does speed up healing and recovery times dramatically so there are advantages, but it does increase the possibility of developing these sebaceous cysts. We recommend that you discuss this option with your doctor in great detail. Some doctors do not use the tissue glue because of the possible complications. Tissue glue is still a fairly new product and the long-term affects are still not documented.

Normal bruising and swelling after surgery can also create a lumpy appearance on your face and neck. We’ve also noted that lumps and bumps occur more frequently in women who have had liposuction on their necks. This can be a result of fat cells that will redistribute themselves and smooth out over time. Sometimes scar tissue can be the cause of your lumps and bumps, creating hard bumpy areas. In addition, as clotted blood is in the process of breaking up and reabsorbing into the body, the blood clots may create bumps under the surface of the skin. When you bleed under the skin, sometimes the blood forms scabs, which take awhile to dissolve when they can’t just fall off. Uneven collagen growth, caused by skin that has been tightened, can also cause lumpiness. If you find small, "pebbly" bumps on your cheeks, they could very well be collagen particles that were stirred up by the surgery and have not settled back into the skin yet. Sometimes after surgery your lymph glands can swell, creating large lumps on either side of your neck. These lumps can be as large as "baseballs". Fly to the Facelift 101: Why Do Lumps, Bumps & Other Formations Occur? section for a more in-depth explanation of the various causes of these lumps, bumps and various formations.

Will I Definitely Experience Lumps, Bumps & Other Formations?

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. Run to the Complications & Risks 101: Separating Lumps, Bumps & Other Formations From Hematomas, Abscesses, and Swollen Lymph Glands Discussion to separate lumps and bumps from complications.

What Might Lumps, Bumps & Other Formations Look Like On Days 4-7?

The sizes and shapes of the lumps will vary, depending on the cause. They will probably be largest and most noticeable when they first appear—which could be as early as day 4—and then gradually diminish over the next few weeks and months. Lumps caused by sutures will probably be fairly small, irregular in shape, or "dimply". Women who experience swollen lymph glands can have lumps that look quite large. A very few ladies said they had two lumps the size of "baseballs" on both sides of their neck, most likely the result of swollen glands. You may also have many small bumps as opposed to few large ones. Lumps like these are most likely due to clotted blood or uneven collagen growth. Sebaceous cysts may have a bluish-grey tint, and feel hard to the touch. Lumps might also appear to fluctuate in size, though this is probably more a function of the degree of swelling you are experiencing than the size of the lumps themselves. As you swell, the swelling "hides" the lumps, and they may seem to disappear and then reappear. If your lumps start being more noticeable, you can be happy that your swelling is going down.

What Might Lumps, Bumps & Other Formations Feel Like On Days 4-7?

Much like the way lumps and bumps may vary in their look, the way they feel can also vary among facelifters. They may feel hard to the touch, and can even be sore and painful. Some women have described their lumps as feeling "rope-like", especially in the neck area. However annoying lumps and bumps may be, take comfort in the fact that the skin on your face and neck is a lot tighter now. If the lumps and bumps are due to dissolving sutures, they are probably painless, and you may very well be able to feel the dissolving sutures under the skin. Moreover, lumps might also itch.

For some women, the presence of lumps and bumps can feel irritating and even somewhat painful, while for others they are a minor discomfort. The good news is that regardless of how you feel about the bumps, they will ultimately come to pass. For the most part, one can expect to be "lump-free" by the six-month anniversary.

Where Might Lumps, Bumps & Other Formations Occur?

The most common areas for lumps and bumps to occur are on the cheeks and neck, especially if your facelift is combined with neck liposuction. A few women, though not so commonly, also had them along the jawline, under the chin, around the eyes and ears, and behind the head. We have noted that when women had lumps around their mouth and cheeks, this occurrence was more frequently associated with dissolving sutures at work. We’ve also noted that of the women who experienced lumps and bumps in the chin area, a good number of them have had a small incision made just beneath the chin during their surgery, for the neck portion of their facelift. Sometimes the scarring from this incision can cause a slight ridge. Asymmetry In Lumps, Bumps & Other Formations

Like many other symptoms, lumps and bumps can occur and be distributed unevenly on both halves of your face and even on the same side of the face. So it is entirely possible and normal if the right side of your face and neck has more lumps than the left side, or if you have bigger lumps on the right side of your cheek but smaller lumps on the right side of your neck, or if you have one lump that is shaped like a small button on the right cheek, but your left cheek is entirely normal.

The speed of healing of each bump can also be uneven. You may have some lumps and bumps that stubbornly persist, long after other lumps have gone away. This is perfectly normal and nothing to worry about. You may feel self-conscious, but often the unevenness and lumpiness is much more apparent to yourself than it is to others. Keep in mind that it is quite normal to still have lumps for up to several months after your surgery, but they will go away, and you will be "lump-free" and turning heads again soon.

Fluctuations: She’s Lumpy, She’s Lumpy Not

The normal pattern of healing for lumps, bumps and other formations in the post-operative period is a gradual diminishing of the lumps until they are completely gone. You will probably notice them getting progressively smaller as time passes. Along the way to their eventual disappearance, some women have observed their lumps seeming to go away but then come back again. This is probably due to fluctuations in swelling rather than the actual lumps themselves reappearing again. As your face swells, the lumps and bumps become less noticeable, and then as the swelling diminishes the lumps and bumps appear to be bigger.

How Might My Lumps, Bumps & Other Formations Affect Me Emotionally?

Because there is virtually no literature on lumps and bumps, a good number of women are surprised and panicked when they are struck by it, as they were not aware of this possibility going into surgery. Most doctors tell us that lumpiness is normal and will go away in time and this is true most of the time, but there is still not a lot of detailed literature that is available to us. Many facelift voyagers do not know these lumps and bumps are a possible side effect of their healing until they actually face them first hand. For these reasons a good number of women are surprised and panicked when they do come across these "lumps", "bumps" and "dimples". Even worse is that there is even less information concerning the different possible reasons for these physical side effects and how they can be treated. This can explain the additional fear that some women experience when trying to understand what these lumps and bumps are on their own. Each contributing factor is different and has its own specific symptoms and treatments. But don’t panic, as we will explain all of these phenomena.

In the meantime, since some lumps may be pretty unsightly and seem to take forever to go away, it is normal to feel frustrated and concerned. You may be unhappy with the way you look and worry if you will ever look normal again. This can be especially distressing if your smile is affected, as physical lumpiness has been rarely known to produce a "hill and valley" look. Smiling and laughing release endorphins, one the brain chemicals that make one feel good and happy. When you can’t or don’t smile, your mood is consequently affected. Ask you PS about the lumps if you are very concerned, but keep in mind that most lumps and bumps should be significantly diminished by about 3 months post-op and disappear altogether by around your six-month anniversary. Your face has just gone through a significant change, and it may well take months for the skin to settle in, relax, and feel comfortable. Every face is as different as the techniques employed by different surgeons, and different techniques cause different types and degrees of discomfort. Unless you are experiencing a great deal of pain and discomfort, you are probably just going through normal post-operative sensations.

How Long Will My Lumps, Bumps & Other Formations Last?

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.

Healing 101: What Are The Healing Tips For Lumps, Bumps & Other Formations On Days 4-7?

Avoid Mirrors

On days 4 -7, the unevenness and lumpiness might be very visible to yourself when you look in the mirror. Therefore, it is a good idea to avoid mirrors as much as possible during the early days of the healing journey. Many of the symptoms are at their worst levels during this period and you may get understandably unhappy and even depressed by the way you look. From the experience of a good many veterans, looking at oneself in the mirror at this time is likely to be a negative experience due the post-op look that you may have. Time and again, women who were tempted to look at themselves ended up feeling blue and wishing they never did check themselves out. Since your psychological state will affect the speed of your healing, you do not want to introduce anything that could upset you – such as seeing a puffed-up version of yourself. Given that your appearance will be changing on a day-to-day basis, looking at yourself at this early phase is of little use and will not serve you well. There is no point to look at yourself in this temporary state, as everything will shortly change. For this reason, you should limit your exposure to mirrors and only use a mirror in times that you really need it such as to cleanse and moisturize your face. Otherwise, the mirror is not a good friend at this time.

Rest And Relax For Your Skin

The best advice for your lumps on days 4-7 would be to let your body and your skin relax. By doing unnecessary activities, you may subject yourself to the possibility of causing certain symptoms such as your lumps and bumps, swelling and bruising to worsen, introducing potential complications, weakening or even (though less likely) causing a suture or staple to come loose or pop off. All of this spells a longer recovery period than the one you would have if you were to take it easy and do nothing at this time.

Please be sure to consult your doctor about all recommendations and products before deciding to follow or use them during your journey.

Facelift 101: Why Do Lumps, Bumps & Other Formations Occur?

Dissolving Sutures

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.

Sebaceous Cysts

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.

Swollen Lymph Glands

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.

Collagen Build Up

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.

Complications & Risks 101: Separating Lumps, Bumps & Other Formations From Hematomas, Abscesses, and Prolonged Swollen Lymph Glands

In some rare cases, lumps and bumps are not part of the normal healing process and should be tended to by your PS. One of the most common complications is a hematoma. If the lump is painful to the touch, dark, or leaking blood, it may be a hematoma and your PS will probably want to drain it. For more details and scientific explanation about what is a hematoma and how it occurs, travel to the Hematoma discussion area in the The Danger Zones: Complications During And After tab in this room.

If the lump is red, raised, and painful, it may be an abscess. Abscesses occur when an area of tissue becomes infected and fills with white blood vessels, your body’s natural defense against infection. They sometimes happen after surgery due to trauma to the skin. If you have an abscess, your PS may want to drain it.

Swollen lymph glands are sometimes a normal part of the post-op period, but if the glands stay swollen for several weeks, 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.

Finally, you may also notify your PS if any bump looks or feels differently than the rest.

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