10 Months Post Facelift. Still Have Depressions on Lower Face. Similiar to SMAS Facelift That Was Performed? (photo)

Depressions still under cheekbones (both sides not even). Surgeon unhelpful. No suggestions 2 massage or to do anything (will that help?). It improved little each month but last 2 mo. don't see changes. Also have what looks like a pea near right side of my mouth. Still swollen, could this be the problem? Bought Negative Ion massager. Need to be ultrasound? Manual massage seems to help. Still swollen. Could this be why? When swelling goes down completely will it help smooth things out?

Doctor Answers 15

Irregularity of contour after facelift

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You look like a young woman in your photos and this might mean that your firm youthful tissue is still holding on to some swelling. Be patient for a while longer - may be 6 months. If the irregularity is still there it looks like a relatively minor revision might do the job. Fat injections into the hollows and steroid injections into the lumps and bumps can have vey nice results.

Diana L. Elias MD

Saint Petersburg Plastic Surgeon
4.7 out of 5 stars 26 reviews

Lumpiness following a face lift surgery

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It appears that overall you had a nice result from your facelift.  These small areas of subcutaneous tissue lumps are not unusual and usually resolve spontaneously.  Your surgeon could consider small steroid injections or microliposucton to smooth out these zones.   These would be combined with massage.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Swelling and Irregularity after SMAS Facelift

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Some differences in the recovery and healing between sides of the face are common after facelift. However, after 10 months, it generally will be evening out. I tell all of my patients to do gentle massage and warm compresses. There are various hand-held devices (massagers, ultrasound, etc.) marketed for swelling reduction. Some of these will help, others will not. However, just using your hand and a little lotion is equally effective. Lastly, for persistent swelling or a small ball of scar tissue ("pea"), injections of a steroid can be helpful. For depressions, fillers or fat grafts are helpful -- though I would recommend waiting until 1 year.

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Facelift after 10 months and Irregularity and Depressions

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     It is possible that there may be some improvement with massage and time.  The depressions can be filled with filler or fat if you wanted to consider that in the future.  The pea that you describe could be almost anything, but this may improve with massage and time as well.  Kenneth Hughes, MD Los Angeles, CA

Healing after a facelift

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Generally speaking, it can take 6 to 12 months to completely heal after a facelift procedure. I would strongly recommend speaking with your surgeon or his/her clinical team to discuss your concerns further.

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 124 reviews

Contour irregularities following facelift surgery.

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Contour irregularities following facelfit surgery are not uncommon.  In the early postop period they are usually related to tissue edema and swelling and improve as the swelling works its way out.  After 6 months or so, any additional improvement will be minimal.  Permanent irregularities are the result of deep soft tissue bunching or overlap.  These can be improved with measures such as steroid injections into the prominent areas, micro-liposuction or micro-fat grafting.

Mario J. Imola.  MD, DDS, FRCSC, FACS.

Mario J. Imola, MD, DDS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 125 reviews


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I can only make a suggestion based on your photographs.Some of this is your normal tissue, and some of the irregularities may be due to scar contracture. Touch ups with a release of the scar and fat fills can be done at any time.Discuss this with your surgeon. All the best

Irregularities after facelift

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The depressions that you see are a taught SMAS flap from the facelift that was performed. The odds of this improving over the next 2 months, when all scars are final, is very slim. The soft tissue redundancy near the right side of the mouth can be soft tissue laxity left from the surgery, but this is hard to tell without seeing you clinically. Swelling does not appear to be the main problem as the lions share of healing is complete in 6 months.  Long-end-short, you could have fillers or fat grafting placed to correct the contour deformities. However, the best, natural and long lasting results would be achieved with a revision facelift. I am sorry that this is the answer I have to give you, but it is the most candid and accurate.
Be healthy and be well,
James M. Ridgway, MD, FACS

James M. Ridgway, MD, FACS
Bellevue Facial Plastic Surgeon
5.0 out of 5 stars 98 reviews

Depressions on Face after Facelift #facelift

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It is common to have irregularities that far out of surgery. There are many things I utilize in my facial surgery patients that help a lot. Massage is the first thing that works well as you have mentioned. Sometimes ultrasound treatments can help smooth things out. Another thing that helps could be lymphatic massage by a lymphatic massage specialist, but likely this far out it won't make too much of a difference. I only mention it because you said massage helps. I use this type of massage with a specialist in town but normally during the first few months after surgery. Finally, if you really truly have long lasting areas of irregularity you could have fat grafting to the areas to contour them.

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 54 reviews

Depressions 10 Months Post Facelift

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There will be minimal changes 10 months after your facelift. The depressions can be augmented and the pea might be reduced with micro-liposuction. I assume you would like to do as little as possible to correct the contour irregularities but I would need to see you to make specific recommendations.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 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.