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SMAS Facelift "Pull" on One Cheek

Hello, I had a SMAS facelift 3 weeks ago. Immediately after surgery the right side of my face was very swollen and almost twice the size of the left side. Now the major swelling has gone, but I see a deep "pull" along with lumps going vertically from my cheekbone down to my neck on the right side and it feels very tight. My left cheek seems to be fine, the tightness almost has gone. My doctor says that there may be a blood clot under the muscle on the right side and eventually it will even out.

Doctor Answers (13)

SMAS Facelift


I agree with your surgeon, this will most likely resolve with time.  Try to be careful that you don't sleep on that side of your face, that can further exacerbate your swelling.  Wearing your compressive facelift garment at night may help as well.   You are still early in your postoperative course so I'm sure "tincture of time" will be your best medicine.

Silverdale Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews



You need to have close follow up with your surgeon.  If you have a hematoma, it needs to be addressed so that it does not affect your longterm results.

Web reference:

Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Swollenface after face lift


You have and are suffering the efffects of a hematoma. Idrain these and repair the bleeder asap. Most hematomas resolve but you may have some uneveness on that side. Follow up closely for the next step.

Web reference:

Los Angeles Facial Plastic Surgeon
4.5 out of 5 stars 6 reviews

Possible hematoma after SMAS Face Lift


 I have performed Face Lifts for over 20 years and from what you describe and the photos, you may have had a hematoma on the right side of your face after the Face Lift.  Typically, when this occurs, part of the incision is opened and the blood clot(s) are removed.  Unfortuneately, hematomas do stretch the tightened SMAS and skin, take longer to heal and wind up making the affected side more loose than the opposite side of the face.  You should discuss this with your Face Lift surgeon.

Web reference:

Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

"Pull" on one Cheek after SMAS Facelift


On the basis of your history and the pictures submitted this swelling and pulling is probably secondary to a post-op hematoma. Follow your surgeon's instructions. This will resolve; ultrasound may accelerate the healing process. 

Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Smas facelift "pull".


Smas facelift "pull" can be caused by many things. If it is not improving in4-6 weeks, I would ask your surgeon about what to do or get a second opinion. In the meantime use ultrasound to make this go away faster.

Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 9 reviews

Face Lift


From your description, it apperas that you may have a hematoma.  These are unfortunate but can happen to all of us.  Most hematomas do finally resolve with time.  Warm compressors and massage may be helpful. 

Orange County Plastic Surgeon
4.5 out of 5 stars 54 reviews

Face lift


It seems that you had a hematoma after your face lift.

When heamtomas are RECOGNIZED, some times it is difficult to recognize, the best approach is to explore, clean and close with a drain.

Now you have the effects of a hematoma. It is difficult to predict the final outcome. only time will tell. So you need to be patient and wait a long time, then deal with the situation as it arises.

Baltimore Plastic Surgeon

Bleeding after a Facelift


Based on the history and pictures here it looks like you may have developed a hematoma after your surgery. This happens when a small vessel bleeds and then the blood forms a clot under the skin. This can cause all the pressure and tightness you are feeling. Ideally hematomas are treated right away by opening the skin and draining them but sometimes they present later.

Keep following with your surgeon carefully and things like massage and ultrasound therapy may be of great help to you. While a hematoma of your size makes the results you want delayed, they do not in a majority of cases have any long term effect when followed closely.

Be well,

Dr. J

New York Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Swelling and Pulling after SMAS lift.


Everyone wants an immediate result - including surgeons! Unfortunately this just isn't how we heal. Three weeks is way too early to tell.Your plastic surgeon is the best person to determine the cause however. The good news is that most improve significantly on their own.Without an exam I cannot diagnose your cause but can make some general helpful remarks that may be helpful.

There are many predictable portions of the healing process that ALL PATIENTS EXPERIENCE. Although both doctor and patients would like to not have this happen, it is part of the healing process.  Massage can some times be of benefit during this time period These Side effects refer to what you will be experiencing from the facelift healing process: Here are some of the common things you will experience. The common side effects include: swelling which is maximum 2-3 days later, bruising (highly variable), numbness which takes several months to resolve,  tightness takes several days to months to resolve, discomfort chewing (technique dependent), discomfort (generally mild with this surgery, nausea (variable) and in some patients emotional lability in some. Although most of the visible edema resolves in 2-3 weeks in mini-lifts and 3-4 weeks in traditional facelift approaches, residual firmness (edema you feel but don’t see) can linger for several months. Skin suppleness also takes a while to return as does scar maturation. I tell my patients it takes up to a year for final resolution of the healing process. In my experience, the above rough time table is usually delayed in smokers, when multiple procedures are performed together and when resurfacing procedures are done at the same time as the lift. The same is true if complications occur such as infection, hematoma, skin loss or compromise, etc.  Facelifts and all surgical procedures for that matter share several possible complications - such as excessive bruising or bleeding (e.g. hematoma), injury to deeper structures, anesthetic complications and so on

Orange County Plastic Surgeon
5.0 out of 5 stars 31 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.

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