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Is Necrosis Behind Ear After Facelift Normal?

Like any surgical procedure, a facelift comes with its own set of risks and complications. Among these, the occurrence of skin necrosis, which refers to the premature death of cells and living tissue, usually due to a lack of blood supply. Following a facelift, it can occur in the skin or other tissues surrounding the surgical area.

Necrosis is a serious medical condition that requires immediate attention to prevent further complications such as infection or scarring.

In the following guide, we explore the causes of skin necrosis and explain what you should do if you find it behind your ear.

Is necrosis normal?

Skin necrosis is relatively rare when the procedure is performed by a skilled and experienced surgeon. While minor bruising, swelling and discomfort are typically expected after undergoing a facelift, necrosis is considered an extreme and serious complication. It can have severe implications for both your health and the final aesthetic outcome of the surgery.

Necrosis can be both life-threatening if it leads to severe infections or other complications. Treatment for necrosis often involves additional surgical interventions to remove the dead tissue, which can leave significant scarring. This can not only compromise the aesthetic goals of the facelift but also add emotional and psychological stress to the patient.

What causes necrosis?

Skin necrosis following a facelift is often a result of various factors. One of the main causes can be improper surgical techniques or errors made during the operation. For example, over-tightening of sutures can impede proper blood flow to the skin, leading to necrosis. Additionally, if there is inadequate control of bleeding during the surgery, this can also compromise blood supply and create the conditions for skin necrosis. The technique used to lift the skin, commonly referred to as the skin flap technique, can also be a cause. Errors in the surgery can cause a lack of blood supply to certain areas, notably behind the ear.

The surgeon's experience and skill level are vital in preventing facelift complications such as necrosis. Before having any kind of cosmetic surgery, verify your surgeon's credentials, seek patient testimonials and ask for before-and-after photographs of previous surgeries they have undertaken.

Your lifestyle choices and pre-existing medical conditions can also play a role. Smoking, for instance, can be a major risk factor. Nicotine constricts blood vessels, impeding the blood flow necessary for healing tissues. Likewise, your medical history, such as existing conditions like diabetes, can affect both healing and blood circulation. Certain medications like blood thinners may also impact the natural healing process and should be discussed with your surgeon before your procedure.

The level of care you receive after the surgery is just as important as the procedure itself. Poor post-operative care can result in infections, which can lead to skin necrosis. If you do not have follow-up appointments, you and your surgeon may miss any early signs of complications, and neglecting or ignoring early symptoms can lead to a worsening condition.

Signs and symptoms

Recognising the early signs and symptoms of necrosis is essential to making sure you get the medical support you need. Doing so can minimise the risk of severe, long-lasting damage. Being vigilant during the postoperative period can make all the difference.

  • Pain or discomfort: while some level of pain is expected after any surgical procedure, an unusual or increasing level of pain around the surgical area could be an early indicator of necrosis.

  • Skin changes: one of the most visible signs of necrosis is the darkening or discolouration of the skin around the surgical site. The skin may appear purple, dark red or even black in severe cases.

  • Odour and discharge: the presence of a foul-smelling discharge from the surgical area can be another symptom. This is often a sign of infection, which may exacerbate the necrotic process. The discharge may be accompanied by other symptoms like increased redness and swelling around the surgical site.

  • General illness: fever or a general feeling of being unwell could be indicative of a broader infection or issue. While these may not directly point to necrosis, you should seek medical attention, especially when seen in combination with any of the above symptoms.

Time is of the essence when dealing with potential necrosis. If you notice any of these symptoms, consult your surgeon or healthcare provider immediately for a proper assessment. Early diagnosis and intervention are essential for managing the situation effectively and reducing the risk of lasting damage.

Preventing skin necrosis

A thorough initial consultation with your surgeon can help both you and them understand what the risks of necrosis are, and what steps should be taken to avoid it. During this stage, your surgeon should take steps to find out about your medical history, including information about any medications you're taking, lifestyle habits like smoking, and pre-existing conditions that could affect healing and blood flow.

Skilled and experienced facelift surgeons use techniques that minimise tissue trauma and optimise blood supply to the surgical site. This includes proper flap techniques to control bleeding, and ensuring that sutures are neither too tight nor too loose. While this is mostly out of your hands, having chosen a reliable and trustworthy surgeon will help to ensure the procedure is done properly.

Wound aftercare is essential in the days and weeks following your surgery. This includes keeping the surgical site clean to prevent infection, taking prescribed antibiotics if recommended, and carefully following any instructions you are given. Regular follow-up appointments with your surgeon are crucial for monitoring the healing process.

Taking legal action

Medical negligence occurs when a healthcare provider fails to offer a reasonable standard of care, resulting in harm to the patient. If your surgeon, anaesthetist or any other member of the medical team was negligent in their duties in regards to your facelift, you could have grounds for a claim. This could be due to errors during surgery, failure to provide adequate post-operative care, or not sufficiently informing you about the risks involved in the procedure, including the risk of necrosis.

If you find yourself in this position, you should speak to an expert medical negligence solicitor - such as those at Cosmetic Surgery Solicitors. We can help you to make a claim for skin necrosis, guiding you through the entire process and making sure you get the maximum compensation amount possible.

To learn more, call us today on 0808 189 7722, or fill out an online contact form and we will be in touch at a time suitable for you.

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Mike Saul


Michael Saul is a partner at Cosmetic Surgery Solicitors, where he brings his extensive specialist legal expertise and passion for helping people to the forefront of his work. With a proven track record of success in cosmetic surgery negligence cases, Michael has dedicated his career to providing clients with the highest level of representation and achieving favourable outcomes.

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