My cheeks are huge after facelift. Are there any options to fix this besides filler? (Photos)

Thank you for the message and the photos. I agree, your cheeks look very large with too much widening of your face. A deep plane facelift will bring some tissue up from the cheek as a part of the lift. So, during a deep plane facelift the cheek mound will get slightly larger and fuller from repositioning the deeper tissue upwards. I use almost exclusively the deep plane facelift technique, but have never seen cheek enlargement to this degree. Did you have fat grafting, cheek implants, midface lift with Endotines, Sculptra or some other type of filler done at the time of your facelift or before/after the procedure? It looks like you live in Utah. It might be easiest for me to see you in person. During your visit I can feel your cheeks and try to figure out exactly what is going on and what the best treatment is going to be. If you go to my instagram page, @drjohnbitner, you can see some examples of "normal" cheek enlargement that happens during a deep plane facelift. You can see on our instagram feed that even early in the recovery when the cheeks may still be a little swollen, no one has cheeks as large as yours. My office can be reached at 801-525-8727. They can help you find a time to come in and meet.

Thank you for sharing your concerns and photos. It's not uncommon to experience prolonged swelling or volume irregularities following a facelift, especially in the midface or cheek area. This could be due to residual post-surgical edema, fat grafting that may have taken or settled unevenly, or changes in soft tissue tension after lifting.

If you're not considering additional filler, there are a few potential approaches:

Time & Observation – Sometimes, residual swelling and fat redistribution can continue to improve gradually for up to 12 months post-surgery.

Ultrasound or RF-Based Contouring – Non-invasive technologies like Ultherapy, Morpheus8, or Thermage can help tighten and refine bulky areas by stimulating collagen remodeling and mild tissue contraction.

Steroid Injections – In cases of fat hypertrophy or persistent localized swelling, low-dose intralesional steroids may help reduce volume.

Liposuction or Fat Dissolving Injections (e.g., Kybella) – For very defined areas of excess volume, conservative micro-liposuction or injections like deoxycholic acid may be considered, but with caution due to risk of irregularities.

Surgical Revision – In select cases where the volume is due to structural repositioning or asymmetry, a revision by an experienced facial plastic surgeon might be an option—but usually after conservative measures and full healing have been assessed.

A detailed evaluation with your plastic surgeon or a facial aesthetics specialist can help determine the safest, most effective next step.

It looks like your lateral cheeks are looking exaggerated for two reasons. First, the skin is lifted and bunched up as a result of the surgery and the other issue is that you have considerable volume loss that is not addressed with a face lift. The good news is, the skin will come down over time and start to look normal again and the laxity that you probably had in the lower face will stay away for many years. The bad news is that this process could take months, sometimes up to a year. My recommendation would be to get an autologous fat transfer to fill in the volume loss in your temples, in front of your ears, under the eyes, medial cheeks and jaw. If done properly, the fat transfer will look very natural and should last as long as the face lift. I agree that fillers are not a good option because trying to address the amount of volume required with filler will make you look unnatural and the filler will need to constantly be replace not to mention the risk of migration. The face lift was just the first step, now you need to complete the transformation by addressing the volume and you will look stunning!

Hello and thank you for the email. Do you have any photos from prior to surgery? This would be helpful to determine what changes occurred. Generally speaking, it does appear as though you have fullness over the malar region and likely some volume deficiency in the submalar region which is accentuating the transition from one area to another. Happy to review further photos if you are able to provide them. An in person consultation with a facial plastic surgeon may be of benefit to you.

You may still have residual swelling from your facelift giving your cheeks the exaggerated appearance. Before considering filler or fat transfer you want to allow yourself to fully heal from the surgery. Fat transfer is an option to give you longer lasting results. Another option is Sculptra. I've included a video that I hope you find helpful.