Flattened cheeks post deep plane facelift - can it be repaired? (Photos)

Hi there,

I completely understand how distressing it can feel to notice changes in your face after surgery, especially when you were hoping for a refreshed and lifted appearance. What you’re describing — flattening of the cheeks, a sense of heaviness in the lower face, and tightness — can happen for a few different reasons, and it doesn’t necessarily mean that something “went wrong.”

In the early months after a deep plane facelift, there’s still a lot happening beneath the surface. Even at five months, swelling, scar tissue maturation, and subtle internal healing can continue to reshape how the tissues sit. The tight feeling is often from internal fibrosis or scar formation — this can make the midface feel firm or appear slightly flattened when you smile.

Your surgeon’s mention of fat atrophy is also possible. Sometimes, during or after surgery, the natural cheek fat pads lose a bit of volume due to repositioning, reduced blood supply, or postoperative inflammation. This can make the midface look less full and the lower face appear heavier by contrast.

The good news is that this can often be improved. Depending on what’s contributing most to the change, treatments such as fat grafting, strategic filler placement, or soft tissue release can restore balance and natural volume. These approaches can be done months after surgery once healing has stabilized.

When it comes to expressing your concerns, I recommend approaching your surgeon with honesty and calmness. You might say something like:

“I’m grateful for your care, but I’ve noticed some flattening and tightness that make my face look different from what I expected. Could we discuss what might be causing it and possible options to restore balance?”

This communicates that you value their expertise while expressing your valid concerns clearly. Most surgeons appreciate when patients share their feelings — it helps guide any next steps together.

Hello, thank you for your question, we can do stem cell included fat injection to face ( for fat atrophy).
If you want to check the doctor's Instagram page, I added the link, you can take a look and have an idea about the surgery.
We can offer you a virtual consultation for a better evaluation, please send us your full name and phone number on our email: hi@estherianclinic.com. We will contact you as soon as possible.
Hope it helped!