Hi, I have performed many SMAS facelifts for over 30 years and have performed many minimally, invasive SMAS facelifts. From the photos (at 4 weeks post op), the lumps may require some intervention. Follow up with your facelift surgeon, hand held ultrasound can help. The issue is with the unreliable nature of fat when used for facial shaping. I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin), liposuction and/or facelifts for over 30 years. In my experience and despite its recent increase in popularity, fat transfer (fat injection) offers "far" less of a reliable and predictable volume for facial shaping than an off the shelf dermal filler or silastic facial implant. For that reason, I do not use fat to shape the cheeks, chin, lips or jaw line. Tissue physiology is quite simple. Tissue requires a blood supply in and out as well as lymphatic connections to remain viable and alive. Once fat is removed from the body all of these things have been disrupted. Just because the removed fat is mixed with PRP or something else doesn't make the blood and lymphatics magically re-appear. The fat at that point is not living tissue which means that it's prone to being dissolved by the body (most likely in an uneven and unpredictable manner). Injecting fat back into the face does not create the required elements to make the fat living tissue once again. So the argument that fat is alive and viable in the face once it's been removed and re-injected makes no sense to me as a physician and surgeon. The other issue that I have with fat transfer is the lack of precision. Fat is thick by nature which means it's not the same consistency as an off the shelf dermal filler. Fat injections use an increased volume injected in an attempt to compensate for the volume loss that "will" happen. This means a lack of specific shape and volume that simply can not begin to compare with the specificity of using a silastic facial implant of a "known" shape and volume. In that regard fat offers too much of an unknown to make it a reliable and predictable method for facial shaping. There's a significant difference between a 3mm and 5mm thick cheek implant. You can imagine the magnitude of difference there is between retaining 60% of 25cc's of fat versus 35%. In my humble opinion, I just don’t see how fat could possibly be used to precisely shape facial features? The more invasive type facelifts can have minor lumps and bumps for up to 12 months which is why the minimally, invasive face-lift has gained popularity due to it's limited dissection and rapid recovery. Only so much can be done to decrease the bumps (massage, ultrasound and liposuction (if this is an isolated clump of injected fat), the rest will take time to resolve. If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift. The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last). The excess skin is then removed and the facelift incisions closed. My most popular SMAS facelift is the minimally invasive, short incision SMAS facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits: very small incisions and no incisions extend or are placed within the hair. minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned) can be performed in 90 minutes or less, with or without general anesthesia no incisions within the hair = no hair loss excess fat can be removed from the face and neck excess skin removed from the face and neck cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants most patients fly back home to parts all over the world in as little as 3 days post-op I combine facial shaping with every facelift procedure. When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face. Finally, the reality is that there are many different ways to perform a facelift from incision length, incision placement, level of tissue dissection (skin only, SMAS, Deep Plane, Subperiosteal), different degrees of tissue undermining, how to lift and support (imbrication versus plication of the SMAS layer), how much excess skin to trim, is excess fat going to be reduced and finally will the overall shape of the face be made more feminine or masculine (while avoiding the over pulled, windswept appearance). Board certification by "any" specific board alone is not an implied guarantee of results. I have been a board certified facial plastic surgeon with The American Board of Facial Plastic and Reconstructive Surgery since 1993. There are several boards that certify plastic and or cosmetic surgeons (summarized below): The American Board of Facial Plastic and Reconstructive Surgery for facial plastic surgeons that specialize in plastic surgery of the face, head and neck area. The American Board of Plastic Surgery for plastic surgeons performing plastic, reconstructive, (some also perform hand and back surgery). The American Board of Cosmetic Surgery for cosmetic surgeons performing cosmetic surgery of the face and or body. You can google each specific board to learn more about them and the specialty they represent. In my experience and humble opinion, board certification by any board (and you can see that since there are at least 3 such certifying boards, no one board can "claim" ownership or superiority in Plastic Surgery..doing so is more "hype" and "marketing" than fact), so logically there must be some other way to find the surgeon that's "right" for you. **Medical Boards of each state keep records of safety and or malpractice issues with all doctors, including any plastic & cometic surgeon. **Avoid price as an initial determination of how your select your plastic and cosmetic surgeon. If it sounds too good to be true it probably is. **Do rely on reputation, experience and of course a "sound aesthetic judgement" on what will or will not make you more naturally attractive. **Finally, always follow that little voice in your head that says this is the right place or perhaps you might want another opinion. Hope this helps.