I am curious to know how, when a patient tries to describe the various sensations during healing, the surgeon can possibly know if these sensations are normal?

Dr. Dean Kane Q & A Q. I am curious to know how, when a patient tries to describe the various sensations during healing, the surgeon can possibly know if these sensations are normal? For example, 6 months after FL/NL & platysmaplasty, I am still having “uncomfortable” pulling sensations in my neck. My surgeon said it was scar tissue contracting, but it doesn’t seem to be easing off. It’s difficult to describe the sensations, & as the surgeon hasn’t had a facelift himself, how does he know everything is OK underneath? A. You ask some very intriguing question! These are best answered by your surgeon as he / she performed the procedure. I have had several procedures myself including a neck lift and trunk liposuction. In both cases, my recovery has featured a progression of sensations based on the dynamic healing process. · Initially, sensory nerves are cut or bruised from the procedure. Those cut will not transmit sensation and your mental feedback is numbness. On occasion, patients say they have various sensations including a false sense that the area does have normal feeling due to “phantom limb, also called phantom pain” syndrome. · When a nerve is bruised or injured without being cut, there is a variety of sensations called dysesthesia which change. You may experience pain of different qualities such as sharp / knife-like, dull and achy, deep and uncomfortable or in my case with liposuction, itchy with a sense of movement which I call “creepy-crawlers”. It all goes away once the nerve has repaired itself and may take 2 weeks to 3 months or more. · Cut nerves such as those following facelift or similar to my necklift must regrow and find its prior nerve sheath but may also rarely grow into other nerve sheaths of sweat glands or ball up into a bundle. Sometimes those bundles hurt and are called neuromas. It they grow into a sweat or salivary gland, the normal emotion stimulating that nerve may actually trigger sweating or saliva production . Most of the time, the growth of the nerve finds a normal sensory receptor and dysesthesias occur until normal sensation returns. This will take longer than a bruise / injured nerve; a year or more. · During the time of healing, scar formation or collagen wraps around the nerve as it adheres all the tissues together. With increasing movement usually greater than 3 weeks until 3 months, a patient will experience pinching, stabbing or other sensations attributed to the pulling of the nerve within the encased tissues. This is a protective mechanism to resist further injury and will soften and resolve. · You may find more information at: https://drdeankane.com/?s=facelift+healing&lang=en and https://drdeankane.com/?s=facelift+sensation&lang=en Discuss with your surgeon or obtain a second opinion from a Board Certified Plastic Surgeon regarding massage and other physical therapy approaches to mollify and hasten proper healing if you need it. I hope this is helpful. All the best.   This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.
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