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What Can Be Done About Cheek Asymmetry After Mid-face Lift with Fat Grafting?

asked 11 months ago by Charlene7 in Los Angeles
Latest answer by Kris M. Reddy, MD, FACS
Question viewed 1,047 times
Tags: cheeks, female, asymmetry, 2 months post-op, combination, options

At 11-days post-surgery, I developed a hematoma on my right cheek. Due to the hematoma, my R cheek felt rigid. Massage has helped to soften the tissue. Now 5-weeks post-surgery, I still have some lumps/bruising. My L cheek is plumper vs. my R. Did the hematoma cause lower fat "take"? Before the fat completes the process of developing a blood supply, is there anything to be done to lower the viability on the L (for symmetry)? I don't want to go through any future fat grafting procedures.

16 answers to What Can Be Done About Cheek Asymmetry After Mid-face Lift with Fat Grafting?

Reoperation 5 weeks postoperatively?

I have received an increasing number of requests for patients who want their surgeries redone because they had a complication or don't like the results... within weeks of their initial surgery. It is necessary to pick a responsible board certified plastic surgeon prior to your procedure, and if a complication or slow healing happens, to stick with them and work through the problem. Not all healing is immediate and symmetrical. In fact, it seldom is! It is almost always... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

www.drbrent.com

Hematoma after fat-grafting and midface lift.

Hematoma after face lifts done by experienced surgeons is 1-2 percent. Fat grafting can be more since it is more superficial. Ultrasound is helpful in treating this for faster resolution.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

www.bevhills.com

5 weeks postop

5 weeks postop is still very early in the healing process. 6 months and thereafter post surgery is when you can consider a surgical revision or other procedures to revise the results. Continue to communicate with your surgeon, and follow his/her post operative instructions as best as you can.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon

5 weeks post-op

5 weeks is still relatively early in healing process after your surgery. There are still irritated nerves and tight muscles. Be patient and continue to follow up with your surgeon as directed. The final take rate of the fat will be evident at 6 months

Sam Naficy, MD
Seattle Facial Plastic Surgeon

Facelift - What Can Be Done About Cheek Asymmetry After Mid-face Lift with Fat Grafting?

It's all in the timing. At 5 weeks post-op, it is still much too early for you to consider a revision - and I don't know of a way to "increase" the take after a fat graft at any time. Bruising is, as noted elsewhere, common with surgery, with facelifts and with a mid-facelift. I think that, at this point, you need to continue to let the surgery resolve on its own. And, of course, stay in touch with your surgeon. I hope that this helps and good... more

Alan Engler, MD
New York Plastic Surgeon

Face Lift

You are still healing and will have to wait until all is smooth again to assess the symmetry. Unfortunately, a hematoma can take some time to absorb and feel normal again. Work with your Board Certified Plastic Surgeon and they will assist you in management of the healing phase.

Vivek Bansal, MD
Danville Plastic Surgeon

Wait at least 6 months

You really need to wait at least 6 months before you consider doing anything to fix cheek asymmetry. If you are still unhappy after 6 months, there are options. see video

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon

Time

Time is on your side. Wait, do not rush into anything. It will undoubtedly improve and you certainly do not want to make anything worse.

Melanie L. Petro, MD
Alabama Facial Plastic Surgeon

Hematoma after face lift

It is not uncommon to develop a hematoma after a mid-face lift. Depending on the amount of the hematoma it can be treated conservatively or it needs to be drained. As far as I can see in the photo, your hematoma was not too severe, looks almost like bruising. At this point, it has been five weeks since surgery; it is still very early to evaluate symmetry of the results of a face lift. I would recommend the patient to wait around six months, then at that point things can be reanalyzed and... more

S. Ozan Sozer, MD
El Paso Plastic Surgeon

www.elpasoplasticsurgery.com

Cheek Asymmetry after Fat Grafting

Post-op swelling after fat grafts to the cheeks can be asymmetrical and persist for several weeks when there is a hematoma. Massage and ultrasound may accelerate your recovery. Hopefully you will not need additional grafting.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

Facelift and Fat grafting hematoma

I feel like others, in that you will ultimately be fine. Your hematoma is resolving and will eventually be completely gone. I agree that external ultrasound is a beneficial treatment for softening the induration after the blood has settled in the tissues. Do tno blame the fat transfer, it could also have been the facelift portion. You may need a little additional fat added down the road some. Certainly leave the left side alone, dont create two problem areas potentially. Be patient. more

Charles Virden, MD
Reno Plastic Surgeon

www.virdenmd.com

Asymmetric cheeks after Face Lift and fat transfer

Sorry to hear about your issue. I have performed many, many Face Lifts over the past 20 years and IMHO, hematomas create several things that prolong the post Face Lift healing time. The blood within the tissues, of the face, is very irritating and causes increased inflammation, swelling and scar formation. This eventually subsides, but can take as long as 6-12 months. The increased pressure of the hematoma can stretch out the SMAS layer and or the skin resulting in... more

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon

Assymetry after a facelift

At this point I would wait a few months as things change and healing continues to evolve. Your biggest mistake would be going back in too soon to try to resolve something that is still evolving. Talmage J. Raine MD FACS

Talmage J. Raine, MD
Chicago Plastic Surgeon

Asymmetry and hematoma after midface lift

Hematoma is the most common complication after any type of face lift, including midface lift. Most hematomas resolve spontaneously, as in your case, however some require additional surgery to control bleeding and evacuate blood clots. Resolution of hematomas does take time, because it takes time for the body to break down and clear a blood clot; it may take several months to fully heal the area. Usually there is no residual asymmetry afterwords; on rare occasions a... more

Alexander Ovchinsky, MD
New York Facial Plastic Surgeon

Patience my dear.

Charlene Hematomas are relatively common. They do slow down healing. However, this will not prevent you from healing. Right now you are in the ugly duckling stage of your surgical healing. This is the phase were you will be lumpy bumpy. You still have bruising and swelling from the hematoma. Please do not worry about needing a revisional surgery now. Time is an amazing thing. Please be patient and let yourself heal.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Fat graft to cheeks

Dear Charlene, Hematomas are certainly a potential complication of face lifting and fat grafting. Massage is an excellent technique to help soften your affected cheek. The process may take as long as 3 to 6 months to stabilize. You may certainly have some differences in fat survival due to the hematoma. If there are significant differences after the 3 to 6 month period, fat grafting is really the only option for long-term results. Be patient and your surgeon will help you through the... more