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Possible Risks and Complications

Everybody hopes for a smooth, trouble-free surgical procedure and recovery but in reality this is not possible for every single patient. Surgery and recovery are complex biological processes and sometimes there are associated problems. Whilst it is true to say that by far the majority of patients having an Advanced Mini Facelift have a trouble free procedure and recovery, you do need to be aware of the possible complications.


What are the possible complications after an Advanced Mini Facelift?

Although complications are rare the most common complications of an Advanced Mini Facelift are:

  1. Superficial Wound infection. This occurs in 2 to 3% of patients and is treated with antibiotics.
  2. Lumpiness of the scar can occur and the incision is designed so that any lumpiness is hidden behind the ear. This occurs in 2 to 3% of patients and can be treated by a minor corrective procedure, typically after about a year.
  3. Haematoma formation (a collection of blood in the tissues), due to excessive post operative bleeding. The average incidence of haematoma formation after facelift surgery is 7%; the incidence is less than 1% for the Advanced Mini Facelift in our hands.

Also reported are (although we have never seen these after an Advanced Mini Facelift):

  1. Facial nerve damage and
  2. Severe infection and skin loss


How common is numbness and altered sensation in the face? How long does it take to resolve?

This is not a complication; it is to be expected after facelift surgery. Almost all patients experience some altered facial sensation in the first few months after an Advanced Mini Facelift. It resolves spontaneously in about 8 to 10 weeks, although rarely it may take up to a year to disappear completely.


How common is wound infection?

Less than 5 percent of patients develop a minor wound infection. This is easily treatable with a course of antibiotics and does not significantly affect the cosmetic outcome of the procedure. Wound infections (and post-operative bleeding) are significantly more common in people who smoke.


How common is lumpiness of the scar? Can anything be done about it?

Again, perhaps two to three percent of patients undergoing an Advanced Mini Facelift develop this problem. It is a predictable technical consequence of the procedure: when the excess skin is excised, it is 'taken up' in the scar behind the ear. Any 'puckering' or 'lumpiness' will therefore develop behind the ear, where it cannot be seen. This usually responds to self-massage, but occasionally persists. It can be resolved by excising any redundant scar tissue, usually about one year after the initial surgery. This is a simple procedure that can be carried out under local anaesthetic as an outpatient. There is no additional charge for this procedure - it is included in the cost of the Advanced Mini Facelift.

It should be specifically pointed out that any lumpiness of the scar does not affect the wounds in front of the ears. These typically heal very rapidly without lumpiness or any associated problems.


How common is haematoma formation? What can be done about it and will it affect the final outcome?

Less than one percent of our patients develop this complication. It is related to excessive bleeding in the immediate post-operative period. We have made incremental improvements in our surgical technique and post-operative treatment regime over the years and now routinely use a drug called tranexamic acid. Together these strategies have significantly decreased the incidence of haematoma formation. However, it is not possible to remove the risk entirely. We do not operate on patients who continue to smoke or have taken non-steroidal anti inflammatory (aspirin-type) drugs within the last six weeks, as both of these factors increase the risk of haematoma formation.

Treatment depends on the degree of haematoma formation. Large, rapidly expanding collections of blood require immediate surgical intervention. Lesser degrees of swelling can be expected resolve spontaneously. Whether to re-operate or not is a judgement call that is down to the experience of our surgeon.

In the event that you do develop a post-operative haematoma, you will obviously develop more extensive bruising and be more swollen and for longer than normal. However, the final cosmetic outcome will normally be unaffected.


How common is failure to achieve a satisfactory cosmetic result? What can be done about it?

We have had a handful of patients over the years that, in the opinion of both the surgeon and patient, have not had an effective outcome from the Advanced Mini Facelift procedure. The reasons for this are unclear, although scarred, inelastic skin may have been a factor. In the event of an unsuccessful outcome, we are happy to either refund you the surgeons fees of your procedure or to re-do it at no cost to you.


I understand facial nerve damage can occur after a facelift. How commonly does this happen and can anything be done if it happens?

All facelift procedures carry the intrinsic risk of facial nerve damage. The more aggressive the surgical approach, the greater the risk. Mini facelift procedures, such as the Advanced Mini Facelift, carry a significantly lower risk of facial nerve damage than the traditional full facelift. Facial nerve damage leads to drooping of the face on the affected side. It is an untreatable condition and can be permanent. We have never had a single patient who has suffered facial nerve damage after any form of facelift. However, this does not guarantee that it will not happen to you.


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