Help with fluid filled malar edemas (Photo)

I had a facelift with coral cheek implants 3 months ago. I immediately developed malar edemas on both cheeks. They go away when I lie down sleeping but come back in the morning when i get up, no doubt due to gravity. Is this permanent or will they resolve in time? Can anyone please advise what I may do to make them go away.

Doctor Answers 10

Water bags under the eyes post #cheekimplants? Festoons?

Thank you for your question and pictures.

It is possible to see malar swelling post cheek implants and also after fat grafting and also fillers.  It often resolve in 1-3 months.

Rarely, a reaction to the implant is the cause.  

Most other times, the patients are prone to "festoon" and any surgery or procedure in the same region can exacerbate this anatomical predisposition.  Diluted steroids can help but should be done carefully and in small dose as steroids around the eyes can rarely lead to glaucoma.

Hope this helps!

Best regards,

Dr. Marc DuPere, Toronto Aesthetic Plastic Surgeon

Toronto Plastic Surgeon
4.8 out of 5 stars 59 reviews

Malar edema

Typically patients with prolonged malar edema had it pre-operatively , but not as severe as that seen post-op. Your photos are more consistent with peri-orbital edema.  As the lymphatic system recovers  which in extensive facial dissections can take up to 6 months, and normalization of drainage occurs your edema should resolve.   Be patient and follow up with your surgeon . Regards.

Malar edema

It is unusual for the malar edema to persist three months following implant placement. I would follow up with your surgeon for re-evaluation and management. Sometimes I will inject Kenalog or perform laser treatments to help resolve this issue; however, what needs to be ruled out is the possibility that you are experiencing some type of reaction from the implants themselves. Good luck!

Mark Been, MD
Barrington Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Persistent edema

As previously stated, it is unusual for you to have this much edema 3 months post op. I recommend you see your surgeon sooner rather than later for your options, which may include steroid injections or possibly removal of the implants.

Clayton L. Moliver, MD
Houston Plastic Surgeon
4.5 out of 5 stars 27 reviews

Persistent malar swelling after placement of impla during a facelift.

The swelling you have at three months is very unusual. Some patients do have protracted swelling of this area but nearly always heals with the passage of time. I sometimes used dilute steroids in the area in particularly refractory cases. You also might be having some unexpected reaction to your implants. There is the remote possibility that removal may be necessary.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 32 reviews

#facelift #cosmeticsurgery #recovery #scars #beauty

Dear Melbgpo

Thank you for your question and photo! I am sorry you are having trouble.  There are 2 products that can help-
With Warm Regards
Trevor M Born  MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 102 reviews

Malar implants

At 3 months persistent edema over the cheek implant is concerning. An implant reaction is not typical,but recurrent edema is unusual also. Your surgeon should be able to manage this problem or remove the implant. Fat grafting can help when the tissues settle. Voluma may also be an option if the malar implants are removed.

William C. Rigano, MD
Dayton Plastic Surgeon
4.8 out of 5 stars 9 reviews

Coral block cheek implants - severe malar edema

Thank you for asking about your coral block cheek implants.

  • I am very sorry this has happened.
  • Coral block cheek implants are reported to work well but are not approved for use in the USA.
  • There are no very large studies into them either.
  • Persistent edema with no improvement for 3 months suggests that either you are allergic to something in the coral or there is an infection.
  • Ask your plastic surgeon to do an ultrasound to see if there is evidence of infection around the implant.
  • A steroid injection may help if it is an allergy.
  • If it doesn't resolve, you and your surgeon will need to discuss their removal.
Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.

Swelling with coral cheek implants

I dont have any experience with this particular implant, but your surgeon might want to try some kenalog injections in the area of edema. The swelling may get better with time on its own, but this could potentially speed the process up.
wishing you best of luck

Help with fluid filled malar edemas.

Thank you for your questions. It is unusual to have this type of swelling from a facelift at 3 months post. Speak with your surgeon to discuss your results and concerns. 


Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 414 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.