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

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.

Doctor Answers (19)

Facial asymmetry corrections

+1
Fat grafts may be permanent, but the percentage of fat that lives may be variable.  Other factors such as a postop hematoma may have an affect on your outcome.  One several months have gone by to allow time for the swelling to resolve, you might consider small amounts of a facial filler such as Juvederm or Voluma to improve your result.  Good luck.


Los Angeles Plastic Surgeon
5.0 out of 5 stars 19 reviews

Cheek asymmetry after midface lift

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  At eleven days postop, it is still too early to assess the results of your procedure.  I agree with the massage of the affected area to hasten the resolution of the hematoma.  But it will take time (measured in months, not in days) and it is important to be patient before coming to any conclusions.  I am sure that your doctor will work hard to make sure that you will be happy with your results.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.5 out of 5 stars 37 reviews

Mid face assymetry

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You are still very early in the process. I would certainly wait before making any judgments. Infections, hematomas and seromas can can all dervease fat take when they happen early.  Speak with your surgeon and follow his/her direction, but for now wait  until things heal.

Raj S. Ambay, MD
Tampa Plastic Surgeon
4.0 out of 5 stars 14 reviews

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5 weeks postop

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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
4.5 out of 5 stars 16 reviews

5 weeks post-op

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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
5.0 out of 5 stars 137 reviews

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

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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 luck,

Dr. E

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 148 reviews

Face Lift

+1

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
5.0 out of 5 stars 9 reviews

Wait at least 6 months

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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.
 

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Time

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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
5.0 out of 5 stars 11 reviews

Hematoma after face lift

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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 decision can be made.

S. Ozan Sozer, MD
El Paso Plastic Surgeon
5.0 out of 5 stars 19 reviews

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.