Facelift/Fat Graft Prolonged Swelling?

I had a facelift/fat graft (nasolabial/cheeks) 9 months ago. Incisions healed well with very little scarring, but after surgery my face blew up with hard swelling that has lasted all these months and has gone down very slowly. Still not completely resolved- the area in front of my ears is still hard. The night of surgery I got sick and my compression bandage was removed and left off overnight. I was told later that this could cause prolonged swelling- could this be the reason I am still swollen?

Doctor Answers 14

Full Face after Face lift and Fat Grafting

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At 9 months  I agree that facial swelling is pretty much gone. The issue may be in the redistribution of your tissues in the upper face compounded by your surgeons fat grafts. Obviously we are side line quarterbacking and it is extremely diffficult to help you without before and after photos. I would have you ask your surgeon how much fat was actually placed and exactly where was it placed. If you are full in the areas where the fat was placed, maybe check the scale. If you have gained significant weight and you have healthy fat grafts then your face would for sure look fuller. Good Luck.

Reno Plastic Surgeon
5.0 out of 5 stars 70 reviews

Prolonged swelling aftyer fat graftinand facelift, is it normal?

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The swelling after a face lift will subside anfter a couple of months at the most. Your long term swelling is probably due to fat grafting. If a lot of fat was used in one area that fat normally doesn't get blood supply and creates a hard area which we call fat necrisis. It is difficult to give you a valid opinion without seeing before and after pictures and studying your operative report. I am sure your plastic surgeon can help you understand what is causing the problem.

Healing 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

Fat Grafting or Hematoma Causing Hardness after Facelift and Fat Grafting

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   If there is hardness 9 months after facelift and fat grafting, this could represent scar that is taking longer to mature.  However, consider fat necrosis or an unrecognized, small hematoma that increased the hardness of the area.

Swelling After Facelift/Fat Graft

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What you describe is quite atypical, especially at 9 months post op.  It
may make sense to do some steroid injections into some of the areas of
swelling, and maybe a course of oral steroids may be of some benefit.

Jeffrey Epstein, MD, FACS
Miami Facial Plastic Surgeon
4.7 out of 5 stars 145 reviews

Swelling After Facelift

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Though it's always suggested that patients follow proper post-operative care, this is most likely not the reason that you're still experiencing swelling. It's possible for patients to take more than 9 months to heal completely. If you're concerned, I suggest visiting your plastic surgeon to make sure there is no infection and to assure that you're still healing properly. It's important to remember that everyone heals differently.

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.1 out of 5 stars 9 reviews

Facelift Swelling

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It is very doubtful that you would still have swelling 9 months after surgery.  This hard area in front of your ear may represent scarring.  The are many reasons for scarring but leaving the compression dressing off overnight would not be the first reason I would think of to contribute to the issue in front of your ear.


Dr. ES

Prolonged swelling following facelift

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Sorry to hear about the issues you are experiencing following surgery. In general, the side effects of a facelift may include:

1) Swelling
2) Bruising
3) Temporary numbness
4) Nerve injury that is usually temporary but can sometimes be permanent

It generally takes 6-12 months to see the final result of a facelift, and it is not abnormal to have a little bit of residual swelling present at this time. Everyone heals at a different pace, and it is difficult to tell exactly when any leftover swelling will resolve. It is not likely that the issue with the compression bandage is the cause of any prolonged swelling. The fat grafting may potentially cause an issue with blood flow, but it is difficult to say without seeing you in person. It would be best to speak with your surgeon regarding any concerns you have. Thanks and good luck!

There may have been a hematoma

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Thank you for the question.  Although swelling is normal after a facelift the type and length of swelling you are describing makes me suspect you may have had a hematoma.  The vomiting as well as the firmness just in front of the ears is consistent with this.  The hematoma is unlikely to still be there but in its place some collagen/scar tissue is likely to have been deposited.  At this time I suspect diligent massage and time are the two most helpful tools.

All the best,

Dr Remus Repta 

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Should I still be swollen 9 months after surgery?

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I agree with the other opinions regarding the fact that the vast majority of swelling should have resolved by 9 months. If you had a hematoma following surgery it's possible that this could be delaying the healing progress. It's also possible that you have more retained fat in this particular region giving you a more full or swollen look. I would stay in close touch with your surgeon to ensure that you are healing normally.

Todd C. Miller, MD
Newport Beach Facial Plastic Surgeon

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.