Fluid on Cheeks After Facelift

i had an upper bleph and face lift 4 months ago - everything looks ok except for the pockets of fluid which have appeared on my upper cheekbones. i did not have this problem prior to surgery. it seemed to appear 4 weeks after surgery. my eyes sometimes feel dry. i dont smoke. will this resolve over time.

Doctor Answers 6

Cheek swelling

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I agree that fluid/swelling in the "malar bags" is difficult to treat.  These are typically hereditary and can fluctuate from day to day.  I start with fillers (synthetic or fat) deep to the bags closer to the cheek bone itself.  This results in a subtle cheek expansion which makes the bags less noticeable.  If the bags are still severe,  I have used lasers and direct excision both with success.

Kansas City Facial Plastic Surgeon
4.8 out of 5 stars 48 reviews

Fluid after facelift and eyelid surgery

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  I agree that this fluid may have been present before the surgery and you may not have noticed it before.  I would ask your doctor to look carefully at the "before" photos to be certain.  I usually state that any swelling which occurs as a result of the surgery abates over 6-12 months.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.8 out of 5 stars 140 reviews

Fluid on Cheeks 4 Months after Facelift

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Pictures would be very helpful. Why do you think there is an accumulation of fluid? The fullness of your cheeks may be secondary to elevation of the adjacent tissue with the facelift. Dryness of your eyes can occur if you cannot completely close your eyes after the upper lid bleparoplasty. Discuss this with your surgeon or get a second opinion. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Fluid on cheeks 4 months after Eyelid Surgery and Face Lift, now what?

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 I have performed Face Lifts and Eyelid Surgery for over 20 years and even though you have not included photos, IMHO, you are describing "malar bags".  These are fluid accumulations on the upper cheeks from chronic fluid retention that creates scarring within the tissues.  These appear over many months and I suspect these were always there and perhaps hidden by lower eyelid fat bags which they can often be misdiagnosed as only to appear more prominent after lower eyelid surgery.  There is no easy treatment to remove malar bags.  Fillers like Perlane, Juvederm and Restylane can soften and feather the edges of the malar bags and if aesthetically indicated, Cheek Implants can hide their appearance.  Other than that, restrict your salt intake in an effort to avoid larger bags.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Cheek bags

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Although it is hard to tell without seeing your pictures what you are describing is possibly festoons - it would be best to discuss this with your surgeon

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Facelift - Fluid on Cheeks Afterwards

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It is very important that you obtain and review your pre-operative photos.  While I have no way of knowing exactly what you looked like my general experience is that this problem - swelling in the malar (cheek) regions - is more likely to be present in patients who had above-average excess tissue before hand.  Malar pouches can be difficult to remove or address but, as you suggest, can often become more noticeable when the areas around them have been improved and they have not.  Lipo can be done on the pouches though often with variable success.  But while it can take up to 6-12 months for all of the swelling to abate, this area may continue to be troublesome.

I hope that this helps, and good luck,

Dr. E


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