Jordan Cain, MD

Restrictions after face and neck lift are most important in the first few days and weeks after surgery. During that time, tissues and incisions are still healing and are more delicate. Typically, I don't have patients start to massage anything until at least 4-6 weeks after surgery if any massage is indicated, and massage should always be gentle and performed in the appropriate way. Early and aggressive massage could conceivably cause an incision to open or a suture to break, and this may be what your surgeon was referring to regarding "massaging away your facelift." Increasing your heart rate or blood pressure significantly with exercise such as HIIT workouts in those early days can also increase swelling or even cause blood vessels in the area of surgery that are still healing to rupture and cause bleeding underneath the skin. I have patients wait for 2 weeks before restarting any exercise, and I tell them to slowly work back up to their previous activity levels over a period of 1-2 weeks. At 6 weeks after surgery, most tissues will have healed with enough strength that restrictions should be minimal. In the long term, a facelift that was done appropriately by repositioning the correct tissue layers with the right technique should not be affected by sleeping position, running, jumping, plyometrics, or any other form of exercise. Each patient heals at a different rate, and it is important to always follow up with your surgeon regularly in the postop period for advice specific to your case. Hope that helps!

Swelling following open rhinoplasty is very common for the first several months after surgery, and it is not uncommon for this swelling to fluctuate in severity. However, it is always best to address any concerns you have after surgery with your surgeon so that they can ensure the healing process is proceeding as expected. Best wishes,

The cost for earlobe repair can vary widely based on your location, and also may depend on the complexity of the repair. In general, a simple repair will cost between $400-600 per ear, and the cost per ear is often slightly less if both ears are repaired at the same time. This is a quick procedure that is usually done in the office under local anesthesia. There are subtle nuances to obtaining the best cosmetic result, so make sure to consult with a surgeon who has extensive experience in this procedure. Best wishes,

While the hole in the earlobe will shrink somewhat once the gauge earring is removed, this is unlikely to shrink back to the degree that it will let you wear a normal earring, and certainly would be unlikely to close completely. Once the earlobe has been stretched and the gauge has been removed, the only way to adequately achieve a cosmetically acceptable result is with earlobe reduction surgery. Fortunately, this is a quick and relatively inexpensive procedure that can be performed in the office under local anesthesia.  Best wishes,

Buccal fat pad reduction can be an option to consider in carefully selected patients with prominent lower cheek fullness, or what some refer to as "chipmunk cheeks." It is difficult to be certain from your photo, but it does not look like you would be the ideal candidate for this procedure. In a young patient such as yourself, removing buccal fat can cause you to look prematurely aged as you get older and the remaining facial fat that you have shrinks and descends, as it does for everyone as the natural aging process progresses. Liposuction can be a great procedure to remove fat from the jowls and under the chin, but again this is likely not the procedure that would give you the facial definition and inverted triangle appearance that many find desirable. Instead, I would consider augmentation of the upper cheeks with fillers or implants, and possibly Botox to the masseter muscles that overlie the jaw in order to slim the lower portion of the face without permanently removing fat from an area that is essentially impossible to replace.  Best wishes, 

The buccal fat pads are located in the lower portion of both cheeks, and in some patients large buccal fat pads can create chubby "chipmunk" cheeks. Removal of these fat pads or reduction in their size is typically performed through an incision on the inner surface of the cheek. This procedure is not appropriate for everyone, and patients should be very carefully selected. As we age, we lose some of the fat in our face naturally, which is part of what makes a face look older. In the incorrectly selected patient, removing any portion of the buccal fat pad may lead to a gaunt, aged appearance, if not initially then later down the road when the aging process causes atrophy of the remaining facial fat pads. There are other procedures which can provide the slimming effect that you are interested in without removing any fat, such as augmentation of the upper cheeks with fillers or implants, or Botox injection to the masseter muscles that lie over the jaw. I recommend scheduling a consultation with a facial plastic surgery expert who can evaluate your concerns in person in order to determine which procedure or procedures would be most likely to give you the results you desire. Best wishes,

Every patient heals differently, but in general it can take about 3 months to see the full effect after buccal fat pad reduction. In someone like yourself who had other facial procedures, this may take even longer due to natural swelling that occurs with all of the procedures you listed. As the surgical site from buccal fat pad reduction heals it often contracts in slightly, improving the visible result. As always, if you have any concerns in the postoperative period it is advisable to check in with your surgeon to make sure they feel that you are healing appropriately.  Best wishes,

Buccal fat pad reduction can help slim the cheeks, but as you have found it does not do much to change the jawline. There are several procedures available which can help provide a more sculpted jawline in a young person such as yourself. Excess fatty tissue underneath the chin and jawline can be removed with liposuction, or with a series of Kybella injections, which dissolves the fat in this area. Sometimes adding a chin implant or filler along the chin and jawline can help to improve the definition along the lower border of the face. It is difficult to say exactly what would be best in your particular case without any pictures, and really nothing is more valuable than an in-person evaluation. I recommend that you schedule a consultation with a facial plastic surgeon to determine which option will provide the best individualized result for you. Best wishes,

From your picture, it appears buccal fat pad reduction could be an option for you. However, you should keep in mind that you are young and these fat pads, along with all of the other fat pads in the face, will atrophy and become smaller over time without intervention. For this reason I would recommend only conservative reduction in the size of the fat pads, and not complete removal. Other options, such as Botox to the masseter muscle, can provide slimming of the lower portion of the face without the need for permanent tissue removal. I would advise you to consult with a facial plastic surgeon for an in-person evaluation to assess your concerns and make recommendations on which procedure or procedures are likely to give you the best result. Best wishes,

Reduction of the buccal fat pad can be a great procedure for slimming the lower face, but requires careful selection of the appropriate patient. As we age, fat compartments in the face tend to atrophy, or become smaller, and this is part of what causes a more aged appearance. Some doctors are concerned that buccal fat pad removal will therefore automatically contribute to this gaunt, aged appearance, but in a patient who has a family history of round, "chipmunk" cheeks that stay full even as they have aged, reduction of the buccal fat pad can be safely performed without as much risk of creating a prematurely aged appearance. If you are not a good candidate for this procedure, other options may include augmenting the upper cheeks with filler, fat, or implants to give you that heart-shaped, inverted triangle facial shape that is considered youthful and attractive without needing to remove any tissue. I would advise you to schedule a consultation with a facial plastic surgeon who can evaluate you in person to determine which options would be most likely to give you the best result. Best wishes,