Why Do I Have Ridges on Cheeks After Facelift? (photo)

I am nine months post op and I still have ridges on my cheeks. Will they go away and what is the best course of treatment to help them disappear? Thank you

Doctor Answers 21

Cheek Ridges after Facelift

This is a good question – and I am sorry that you have to ask it.  Common irregularities after a facelift surgery would be resolved by your stage of healing. What is most important to your circumstance is the of facelift you have had performed and the fashion in which it was performed. When excellent pull is applied, but the slack is not taken up or removed the result can lead to bulging in regions that are unnatural. This type of result does not change unless a revision facelift is performed.
Be healthy and be well,
James M. Ridgway, MD, FACS

Bellevue Facial Plastic Surgeon
5.0 out of 5 stars 60 reviews

Contour irregularities following facelift surgery.


Contour irregularities are not uncommon following facelifts. They can result from multiple causes:


·         Bleeding and hematoma formation. This is an early postop complication that usually occurs within the first 2 to 3 days following surgery and presents as a localized uniform swelling with severe bruising over the area. A hematoma needs to be quickly drained as it puts the adjacent skin at risk for necrosis and irreversible scarring.


·         Seroma. This is also an early postop complication but can occur up to 2 or 3 weeks following surgery. Caused by collection of extracellular tissue fluid, these should be drained during normal postoperative follow-ups. They can be prevented or limited by using compression dressings.


·         Sialocele. This is an uncommon event that can show up within a few weeks following surgery when the surgeon has dissected/resected the parotid salivary gland. It presents as a soft fluid-filled swelling and may persist for months. Usually resolve with time but often require multiple aspirations.


·         Tissue bunching or pleating. Usually appears within 3 to 4 weeks following surgery as swelling resolves. Results from not ensuring that the skin and or deep tissues are not properly released and smoothly redraped during the resuspension process of facelift surgery. These tend to improve over time, however, beyond a year or so will likely require revision surgery to fully correct.


·         Inadvertent scarring. This tends to appear late in the healing process. Difficult to correct.


In your situation 9 months following surgery, if the lump of tissue feels firm it is likely due to tissue bunching and will require revision. If it feels soft and fluid-filled it is likely a sialocele.


Mario J. Imola, MD, DDS, FRCSC.


Mario J. Imola, DDS, MD
Denver Facial Plastic Surgeon
5.0 out of 5 stars 72 reviews

Ridges on cheeks after facelift

In general, the side effects of a facelift may include:

1) Swelling
2) Hematoma
3) Bruising
4) Irregularities

After 9 months, it is abnormal to have a bump on your cheek as shown in your photo. It appears to be edema or a pocket of fluid, and should be evaluated by your surgeon. I hope this helps, and I wish you the best of luck.

Cheek bulges after a face lift

Thank you for your question about your face lift result.

  • this is not a normal face lift result,
  • fluid, infection, scar or reaction to purse-string sutures can cause this,
  • unless your surgeon is a Board Certified Plastic Surgeon and has the face lift experience to deal with this, I suggest a second opinion,
  • the ridges are unlikely to improve much on their own. Sorry about the problem. Hope this helps.

Ridges After Facelift Operation

Your question is a good one in that it may help other women with similar problems. First of all, 9 mos is an appropriate time period to wait before asking about options for a repair. Second your problem can under no circumstances be considered "normal". Third, you used the plural of "cheeks", making it seem as though you have the problem on both sides. If this is true then the problem is most likely due to the procedure performed. The ridge seems to be some sort of SMAS tightening done medially with either swelling or laxity or both laterally. Regardless, a revision will most likely be necessary even if these sutures could be massaged free as you would then lose any tightening of the lower cheeks and jawline. Have an honest discusion with your real Plastic Surgeon and I'm sure the two of you can come up with a plan to fix your issue.

Paul S. Howard, MD, FACS
Hoover Plastic Surgeon
5.0 out of 5 stars 7 reviews

Facelift Question

Without your records and op note, I cannot answer this. A second opinion surgeon needs these records to give a response. Discuss this with your surgeon. All the best

Thomas A. Narsete, MD
Denver Plastic Surgeon
5.0 out of 5 stars 4 reviews

Why Do I Have Ridges on Cheeks After Facelift?

 From the photo provided, this ridge and associated area of swelling could be the leading edge of a suture-type lift or from something else.  You should ask the plastic and cosmetic surgeon that performed your Face Lift.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 17 reviews

Swollen cheek after facelift

Your bulge is not normal.  What does your surgeon say about it?  And if being dismissive, get a second opinion.

Curtis Wong, MD
Redding Plastic Surgeon
5.0 out of 5 stars 25 reviews

Cheek swelling 9 months after facelift is not okay

The cheek swelling you have appears to be fairly large. I would guess that this represents a seroma, or fluid collection, related to your surgery. Only an exam by your surgeon can confirm this. Its fairly typical to have some ridges and irregularity to the facial skin a few weeks after facelift surgery, but these issues smooth out with time. 

Facelift Surgery

Dear Canadian Alien, I would need to perform a direct examination to give a proper diagnosis. You should not have ridges especially at nine months post surgery and certainly as drastic as your photograph shows. This is an extremely unusual result and I would certainly see your treating surgeon for some answers regarding your concerns asap! Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 180 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.