SMAS Facelift "Pull" on One Cheek

Hello, I had a SMAS facelift 3 weeks ago. Immediately after surgery the right side of my face was very swollen and almost twice the size of the left side. Now the major swelling has gone, but I see a deep "pull" along with lumps going vertically from my cheekbone down to my neck on the right side and it feels very tight. My left cheek seems to be fine, the tightness almost has gone. My doctor says that there may be a blood clot under the muscle on the right side and eventually it will even out.

Doctor Answers 15

SMAS Facelift

I agree with your surgeon, this will most likely resolve with time.  Try to be careful that you don't sleep on that side of your face, that can further exacerbate your swelling.  Wearing your compressive facelift garment at night may help as well.   You are still early in your postoperative course so I'm sure "tincture of time" will be your best medicine.

Silverdale Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews


You need to have close follow up with your surgeon.  If you have a hematoma, it needs to be addressed so that it does not affect your longterm results.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Swollenface after face lift

You have and are suffering the efffects of a hematoma. Idrain these and repair the bleeder asap. Most hematomas resolve but you may have some uneveness on that side. Follow up closely for the next step.

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Possible hematoma after SMAS Face Lift

 I have performed Face Lifts for over 20 years and from what you describe and the photos, you may have had a hematoma on the right side of your face after the Face Lift.  Typically, when this occurs, part of the incision is opened and the blood clot(s) are removed.  Unfortuneately, hematomas do stretch the tightened SMAS and skin, take longer to heal and wind up making the affected side more loose than the opposite side of the face.  You should discuss this with your Face Lift surgeon.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

"Pull" on one Cheek after SMAS Facelift

On the basis of your history and the pictures submitted this swelling and pulling is probably secondary to a post-op hematoma. Follow your surgeon's instructions. This will resolve; ultrasound may accelerate the healing process. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Smas facelift "pull".

Smas facelift "pull" can be caused by many things. If it is not improving in4-6 weeks, I would ask your surgeon about what to do or get a second opinion. In the meantime use ultrasound to make this go away faster.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Face Lift

From your description, it apperas that you may have a hematoma.  These are unfortunate but can happen to all of us.  Most hematomas do finally resolve with time.  Warm compressors and massage may be helpful. 

Siamak Agha, MD, PhD, FACS
Orange County Plastic Surgeon
4.7 out of 5 stars 106 reviews

Face lift

It seems that you had a hematoma after your face lift.

When heamtomas are RECOGNIZED, some times it is difficult to recognize, the best approach is to explore, clean and close with a drain.

Now you have the effects of a hematoma. It is difficult to predict the final outcome. only time will tell. So you need to be patient and wait a long time, then deal with the situation as it arises.

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

Pulled cheek after facelift

Based on your photos, it seems you may have had a postop hematoma.  These can resolve with time though it may take 6-12 weeks to do so. The use of steroid injections, massage, and compressive dressing may assist in the healing process. Partner with your plastic surgeon to get the best results. 

Mike Majmundar, MD
Atlanta Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews

SMAS "Pull" after facelift

While I cannot be certain whether or not you had a hematoma, you do have focal tension and swelling. Both will resolve with time.

Laxmeesh Mike Nayak, MD
Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 198 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.