Deep Plane Facelift persistent residual swelling - what can be done? (photo)

Question

I had a deep plane facelift and fat transfer to my cheeks in Nov 2021. I have had terrible swelling under one eye, even though no work was performed there. I've have steroid injections with no success. Is there anything to be done?

Jonathan Kulbersh, MD · Answer

Thank you for your question and photo. Without an exam, it’s impossible to make a diagnosis. However, based on this photo alone, the fat pad underneath your right eye appears to be protruding outward. Fortunately, removing the fat pad with a quick, simple procedure should reduce the swelling under your eye. I highly recommend visiting a board-certified facial plastic surgeon to address this issue safely. Undergoing surgery from an untrained professional can result in additional swelling and discomfort.

Brian M. Harmych, MD, FACS · Answer

Thank you for sharing your question and photos. The irregularity is either fat in the lower eyelid (very likely) or poorly positioned fat graft (less likely). A transconjunctival lower eyelid blepharoplasty would likely address this issue. I would not recommend steroid injection into this area as steroid injection could make the problem worse by causing atrophy (or loss) of the cheek fat surrounding this lower eyelid fat.

Gianfranco Frojo, MD · Answer

Sometimes if the fat grafting is performed into the wrong area, it will need to be directly excised. It appears that maybe your fat was grafted into the postseptal or preseptal space of the lower eyelid which would benefit from a lower eyelid blepharoplasty. I would highly recommend seeing a board eligible or board certified plastic surgeon for a physical exam and accurate analysis with safe recommendations for potential surgical options. Best of luck!

Jigar Sitapara, MD · Answer

Good morning from Washington DC,Thank you for your question and the photo. If you have given it this much time and have tried steroid injections, it is possible that this is some fat from the fat transfer. When doing fat transfer, we try to process the fat through several filters to get them into tiny microparticles. If too large a deposit is placed in one area, the fat can turn into a lump like this. If it is fat, the deposit could be removed through a small incision under the eye. I would recommend following up with your surgeon to see if they can ultrasound it or feel for the fat. Best of luck and I hope this helps!Jigar Sitapara, MDChevy Chase Facial Plastic Surgery

Darryl J. Blinski, MD · Answer

Based solely on the 1 posted photo I think that is herniated lateral lower lid fat pad. That could be easily removed under local anesthesia with a minor incision over it and 2 small sutures.

Deep Plane Facelift persistent residual swelling - what can be done? (photo)

Answers (5)

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