Cheeks Swelling After Mid-face Lift?

I had cheek implants 4 years and I have been happy with these. My eyes looked very hollow though and a fat transfer was performed 25 days ago to remedy this. I also had a Mid-face lift. Right now my cheeks are massive. I am really frighten that they are still so huge after 25 days and I'm beginning to doubt if the result will be natural or normal. I can't yet interact socially as I look monstrous. Is this swelling? My surgeon said that the result will be normal but I would really appreciate some other input. Will I look natural in 6-8 weeks?

Doctor Answers 9

Agree with others swelling is natural, expected, and takes a long time to resolve

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Dear Ann

Both fat transfer and midface surgery are associated with long term swelling. It is not uncommon to see swelling from midface surgery last 3 to 4 months. It is enough to drive both patient and surgeon insane. To my mind, there better be unbelievable improvement to justify this time of long term swelling. The fact of the matter is, many have figured out that you can get better results with next to no down time filling the midface with Restylane and Perlane instead of doing surgery.

Fat transfer is another unsatisfactory approach. It works-don't get me wrong. The problem with it is that it is a set up to feeling like you need more fat transfer. Here is what happens. For two weeks after fat transfer you are horribly bruised and swollen. It isn't until about the second month after the procedure that you begin to think that your surgeon was a genius. Mind you, you are still so very swollen. However, by month 4 or 5 the swelling has resolved. At this point, you will be certain that all the fat has disappeared. Typically what is said is "the fat grafting just did not work."

Careful study of the before and after pictures will prove this to be wrong. Usually 60% of the fat survives. However, the brain is greedy. Our natural focus is "How can I look better." Very few of us think "Gee I am beautiful." Three months from now when you are hot to get more fat in your face, seriously consider having a non surgical Restylane/Perlane treatment.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Be patient and wait for the swelling to subside.

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It does take some time for the swelling to settle down after a mid facelift and fat injections. Full healing on a procedure such as this would be more in the three-month range, and you should be patient and wait for the swelling to subside.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

I can't say without seeing the photo.

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 I'm sure it will lessened in the next 4 weeks if it is only swelling. You may wish to get a second opinion tor peace of mind.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

More time needed to heal after Midface Lift and Fat transfer

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Hello Ann,

Based on the fact that you had two procedures done at the same time (midface lift and fat transfer) it is not entirely out of the ordinary that you are experiencing swelling and "distortion" at this point. Fat transfers in and of themselves cause swelling and this can take several weeks to "normalize" (fat is often "overinjected" since we know that a certain amount of the fat will not survive).

Also a factor is the fact that you have a history of cheek implants and presumptively this would have some impact (albeit minimal) on the rate at which your swelling will go down.

All in all the best bet is to continue to follow closely with your surgeon and give your face the time it needs to heal. It is reasonable to expect that in 6-8 weeks things will be looking more "natural" and your expected results more evident.

Kamran Jafri, MD
New York Facial Plastic Surgeon

Swelling after Mid-facelift

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The cheeks are notorious for holding onto swelling after a mid-face lift. Swelling will also differ on the technique used. More invasive mid-face lifts will cause more swelling, but can often give more dramatic results. Swelling from a mid-face lift usually lasts longer than swelling from a facelift or eyebrow lift. So even though you are 25 days out and still swollen, do not pass any judgment on the overall result quite yet. I would recommend following up with your surgeon and expressing your concerns. Sleeping with two pillows and decreasing any strenuous activity are two easy ways to decrease the swelling in the mean time.

Richard Balikian, MD
Murrieta Facial Plastic Surgeon
4.5 out of 5 stars 26 reviews

Swelling after mid face lift

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Thank you for your question for sharing your concerns with us. Swelling and firmness in the tissues will return to normal as time passes by. Between the first and second week, much of your swelling and bruising will dissipate. It may take more than a month or two for your tissues to fully soften and any residual swelling to resolve. Lymphatic massage maybe an option to help clear the swelling and firmness at a faster pace.  I would make sure that you continue to follow up with your plastic surgeon during this period of time.

Swelling after 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

Swelling Following Facelift

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Swelling following facelift surgery varies from patient to patient and depends on the surgical technique and wound healing characteristics of the patient.  The majority of swelling usually resolves in about two weeks following facelift surgery.  At this point, most patients can return to work and resume normal activities.  In most cases, total resolution takes about three months.  In rare cases, swelling may persist for up to a year following surgery.

It’s important to realize that more aggressive facelift procedures cause more swelling, which can last for longer periods of time.  Both facial fat transfers and midface lifts would fall into this category.

Elevation of the head and decreased salt intake may help to decrease swelling after surgery.  In most cases, some swelling is normal following surgery, but persistent or extreme swelling should be evaluated by your surgeon.


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   Significant swelling is the norm after the combination of a mid-facelift and fat injections (transfer). I would expect a significant decrease in the swelling between month 2 and 4 and a gradual decline thereafter. Only time will tell with regards to the final result but you need to wait 4-6 months to truly see an accurate view of your result. Unfortunately surgery does cause swelling and a recovery period. The flip side of the argument is that nothing....absolutely nothing corrects aging like good surgery. Fillers don't even come close and they are very temoprary, and in the end more expensive. As an accomplished facelift surgeon with over 2000 cases in the last 25 years and also someone with extensive filler experience I can honestly say each has its place and is not a substitute for the other. Make sure to get work done only by someone who does both and can choose what is best for you

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.