Cindy MD in Rockville, MD asks:

It has been 3 weeks since I had facelift as part of removing the cyst on my face. I experienced severe hematoma after the surgery, but it seems that everything is healing as expected. I’m concerned about the bruises, since they still look very dark in some areas. The swelling on my cheek and jaw still a bit noticeable and feel so tense. Should I be alarmed? what can I do to better the situation? Thank you for your answer.


It is likely that the hematoma after your procedure has contributed to some of the swelling and discoloration issues. Generally swelling and bruising will take less than three weeks for standard facelift surgery, but with a hematoma then the swelling will last longer. The fact that it is still noticeable and somewhat tense would be not too surprising three weeks after having hematoma formation. Darkness to the skin occurs due to a combination of breakdown of the hemoglobin and metabolism of the hemoglobin due to the deeper hematoma. This contributes to skin discoloration; also hyperpigmentation can occur in these areas. The best therapy is patient observation. Generally with time by itself it will get better. There are medications, topical skin lighteners can help if needed and also other skin treatments such as chemical peels or photofacial laser treatments that can assist. Nonetheless this change at three weeks is expected and not alarming.

David Q. Santos, MD

Seattle Facial Plastic Surgeon