After my surgery, I realized my doctor & I weren't in the same page about the surgery! What are my options?

I fly to US to do my first ever surgery in my life to fix droopiness & excess skin after weight loss. In my 10 minutes preop, I showed him my desired look by pulling skin & fat over my cheeks. After surgery right away I figured something is wrong! I wanted a skin & fat lift plus a quick recovery but I'm left with swollen droopy face with a long Recovery of subperiosteal midface lift! It cost me so much time & money plus a paralysed frozen face

Doctor Answers 9

After my surgery, I realized my doctor & I weren't in the same page about the surgery! What are my options?

Hi, I am sorry to hear about your ordeal. Non smiling photos of your face from the front and side would help in the evaluation. Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.
If the chin is weak chin, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.

 If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face. If you've had an invasive type facelift previously, it would be best to wait 9-12 months before considering a revision.

Hope this helps.

Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Clarifying the goals and procedures pre-operatatively

Thank you for sharing. I am sorry to hear about your experience. This highlights why, in my practice, we have a preoperative meeting for all cosmetic surgeries. With respect to your specific situation, a midface lift does not generally involve removing skin... this procedure helps to lift the fat pads in the upper cheek. It does not address the lower face at all. For this, you need a face/neck lift. The incisions are completely different. Finally, though the midface lift is frequently billed as minimally invasive, this really only describes the incisions. There is still a significant amount of swelling afterward. At this point, please follow up with your surgeon. You may withs to get a second opinion as well.

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 94 reviews

Mid-face lift - not what I wanted

Thank you for asking about your face lift.
  • Without at least before/after photos one can't give you specific advice.
  • I am so very sorry this didn't turn out as your hoped and expected.
  • After extreme weight loss, the usual need would be for a lower face and neck lift.
  • Even with that, there is a lot of swelling and a fast recovery cannot be guaranteed.
  • A subperiosteal mid-face lift has even more recovery -
  • I think the best next step is to discuss your dissatisfaction with your plastic surgeon and give yourself at least six months, ideally a full year, to heal before having anything more done.
Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Importance of communication in facelifts

Communication with your surgeon preoperatively is essential.  It may be that the areas that you expressed the most concern with your surgeon was your cheek or midface area.  A subperiosteal midface lift will definitely address this.  Unfortunately,  the swelling and recovery can be prolonged with this procedure but if it was performed correctly, the results will be quite nice.  If you were looking to have your lower face lifted you may benefit from a mini facelift procedure. It is a relatively quick recovery.  Two days however, is quite early to fully assess your ultimate surgical result and when the swelling subsides, you may be quite pleased with your result.  Good luck. 

Philip S. Schoenfeld, MD, FACS
Chevy Chase Facial Plastic Surgeon
4.7 out of 5 stars 24 reviews

Facelift outcome ... time to heal

Thanks for sharing your question. I can appreciate your concern.
Results after surgery take time. Significant swelling is expected after face lift surgery. Once your tissues are settle, then fine tuning can be made.
Finally, make sure that your doctor is aware of your process. He should be able to guide you best in your care.

Wishing you the best in your journey

Facelift #recovery

Dear Plastic.Surgery.Nightmare
Thank you for your question! Please return to your surgeon , you will need to recover. This can take 6 months to a year.
With Warm Regards,Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 103 reviews

Can be helped

You can be helped.First you need to recover from the surgery which takes weeks and months.Certain things such as fillers/Botox/lasers or skin care can be started during this recovery stage to help you with your appearance.Another opinion can be obtained to help correct issues with the lift.Best wishes,Dr. Denkler

Unhappy with surgical results.

I'm sorry to hear of your disappointment.  It is best to wait till all your swelling is gone and your tissues have fully healed and then address with your plastic surgeon, or another plastic surgeon if you don't wish to return to your original surgeon, what can be done to achieve the results you want.  A revision may be in order, using a different technique such as a lateral SMAS plication, but exactly what would be best would require an examination.

Unexpected recovery time after a facelift.

i'm sorry to hear of your unexpected recovery. 40 to 50% of our patients come from out of town and abroad. Consequently, it is important to convey to any of our patients the realistic recovery time. A midface lift performed endoscopically is a magnificent and reliable procedure but it does  involve significant recovery time in which you will look "freaky" for 2 to 3 weeks after the surgery. After that point you will look good but "fake" for 6 to 8 weeks  and finally after three months or so you will look good.   During the recovery time your face will feel stiff and numb (most of the time asymmetrically so). This will all resolve over time. I have noted that patients that get most depressed after this surgery are those that start off with strong cheekbones. Those with poor cheekbones who undergo an endoscopic midface lift  are delighted with their new cheekbones despite their swelling. This is one surgery in which patients will look worse before they start to look better. Other surgeries such is liposuction, though they are swollen immediately after surgery, will  experience positive reinforcement immediately after the surgery because they will see themselves as being thinner (even though they are bruised and swollen).

Randal Haworth, MD, FACS
Los Angeles Plastic Surgeon
4.6 out of 5 stars 48 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.