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Bulges After Face Lift? (photo)

I had a face lift 7 mts ago. I have a huge bulge on my r. cheek near jaw line and smaller one on left cheek in same area. I had fat put in my lips and believe Dr. put fat in my lower cheeks without my permission. He had tried to draw out non existent fluid in those areas twice. Now he wants to redo lift and see what is going on. I believe he knows. Can this be done evenly? I am beginning to questioning his honesty and knowledge. I am afraid I may end up looking worse. What do you think?

Doctor Answers (10)

Bulging cheeks could be from buccal fat

+2

It's not very clear from the first two photos but I can see bulging of the cheek area on the third photo with glasses.  The right side is fuller than the left.  It seems to be above the bony jaw line.  It's difficult to diagnose over snap shots.  But if I have to guess based on this photo, I say you have pseudo-ptosis of the buccal fat.  We normally have a walnut sized lump of fat tucked under the cheek bone on each side called buccal fat.  This is deep and not connected to fat that belongs to the skin and can't be felt.  It is not seen usually.  In some individuals, the fat slides down into the cheek area.  This process is referred to as pseudo-ptosis (p is silent in both).  You can feel this lump of fat if you squeeze the area gently with the thumb and fingers repeatedly.  It should feel like something is sliding in and out deep under the skin.  The solution is removal of this fat.  It's done simply through the mouth.  It can be done under local anesthesia.  You should talk to your doctor about this possibility and have yourself examined for a correct diagnosis.  

You might wonder why this was noticed only after the facelift swelling is settled.  Buccal fats are often camouflaged by the loose excess of skin and fat near-by.  They become apparent due to the thinning effect of facelift on the jaw-line.  If you examine your before pictures you might see them there hidden among the loose tissue.  By the way, fat grafting is not a likely cause of this.

Hope this is helpful.


San Francisco Plastic Surgeon

Jawline bulges

+1

Either the skin flaps from the facelift were not draped properly or fat was injected into the areas you describe as bulges. In either case I would get a second opinion before having the same surgeon do any revision work. Some surgeons like to put fat along the jawline to smooth out any depressions here and that may have been done. The fat could be removed at this point with gentle liposuction to the area done carefully to avoid creating streaking. Herniation of the buccal fat pad could be a possibility.........but much less likely as the cause.

Richard Galitz, MD, FACS
Miami Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Several potential sources for the contour you describe

+1

Hello Peg,

Thank you for the question and the photos.  I can appreciate the areas in your after photo that you mention.  You before photos are oblique (45 degrees) and your after photo is straight on which can sometimes be deceptive.  The sources for fullness in that area is either buccal fat pad prolapse, fat graft excess, seroma/scar tissue formation, or accumulation of soft tissue from the face lift procedure.  Discuss these options with your plastic surgeon.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 92 reviews

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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.