7 months after face lift still cheeks swelling present - Is this normal? (photo)

Question

Hello, I’m 34 yrs old I have done facelift in Turkey but I’m not satisfied with result. I’m having still cheeks swelling , my checks very soft underneath, sagging?? Specially when I wake up after sleep the swelling is very excessive. I’m not sure is that normal or I need to do some thing .. I want my old face back .. just for your information the swelling after the surgery has been more even that I can’t open my eyes because of it . Thank you

Samir Shureih, MD · Answer

Based on the pictures posted, there is a slight swelling in one side more than the other. specially at the malar fat pad. Because of that the swelling will remain for a long time. Consider revision at one to two years if this still bothers you.

Francis R. Palmer, III, MD (retired) · Answer

Hi, swelling at 7 months post facelift may indicate that you had a subperiosteal or other very aggressive type facelift.  You may want to ask your surgeon "what type" of facelift he/she performed.  That will further define the length of recovery. From the photos, your cheeks are flat in the front, the chin and back portion of the jaw line is quite weak.  Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using silastic cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.
 A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.  I have found placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective. The back portions of the jaw line can be augmented with precise placement of a dermal filler without masculinizing the face.  Fat should not be used to shape the face in my humble opinion (discussed below). Most of my SMAS facelifts are the minimally, invasive, proper SMAS facelift as described below.  I have performed facelifts for over 30 years and have performed many minimally, invasive SMAS facelifts on women in their late twenties and early thirties.  From the photos your cheeks are flat in the front, jowls are present and the chin is weak.  These factors combine to create a rectangular shaped face. 
  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
proper SMAS Imbrication technique
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. 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?
Hope this helps.

7 months after face lift still cheeks swelling present - Is this normal? (photo)

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7 months after face lift still cheeks swelling present - Is this normal? (photo)

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Everything you need to know about Facelift

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