How do you treat an expanding hematoma after a facelift?

Question: How do you treat an expanding hematoma after a facelift and will this affect the result?

Answer: A hematoma following a facelift is an infrequent occurrence (about 2%), but does require immediate treatment when it does occur.  This usually involves returning to the operating room, where the surgeon will re-open the incision, remove the hematoma (blood clot), and identify any bleeding vessels.  Once any bleeding has been stopped, the surgeon will stitch the incision closed again.  In most cases, if identified and treated quickly, a hematoma will have minimal (if any) effect on the result.  A hematoma is suspected when there is presence of excessive swelling and/or bruising underneath the skin immediately following a facelift, or when the fluid in the drain (if placed) is very bloody.  This is in contrast to mild swelling and bruising, which are normal after a facelift.  A hematoma can place pressure on the overlying skin, eventually causing it to die, which is why is must be treated quickly.

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