Swelling - Ice or Heat for Fat Transfer/Bleph?

Question

I am 5 days out of an upper/lower blepharoplasty and full face fat transfer. I am very swollen in my cheeks and my eyes are black/blue and yellow. I thought the swelling would start to decrease by now, but my face is still pretty huge. Can I still do ice? Can I do a warm rice pack? Both would soothe and feel great, I think... not sure if either would harm or hurt.

Stephen Prendiville, MD · Answer

For about 48 to 72 hours after any surgical procedure, swelling will increase incrementally. The swelling with fat transfer can exceed or extend beyond these limits. Use of ice is most helpful for the first 24 hours after a procedure. Some patients experience relief with ice beyond this time frame, but there is no real science to support its use. After this point, head elevation, strict avoidance of strenuous activity, and a tincture of time are most helpful

Jerome Edelstein, MD · Answer

Maximum swelling is usually at about 5 days and goes away over a few months. You should sleep with your head elevated and cut back on salt to help the swelling.

Jeffrey J. Roth, MD, FACS · Answer

It is normal to have swelling and be a bit black/blue after facial surgery. We typically have our patients sleep with their head elevated for the first week. We also have them apply ice for the first week. Arnica, (herbal supplement), can also help sometimes. Please check with your Plastic Surgeon. Make sure he/she knows what is going on.

Kenneth D. Steinsapir, MD · Answer

Please talk with your surgeon. They performed surgery on you, know you much better than strangers will, and they are responsible for how you heal. Here is the truth about full face fat transfer: it makes you look like you were beaten with a baseball bat for 12 days. It will be that long before you can feasibly hit the fact that you just had surgery. Cold compresses will not speed the resolution of the facial swelling. Only time will do this.

Edward E. Dickerson, IV, MD · Answer

Swelling is quite normal 5 days out as well as bruising you described.Ice could be helpful in soothing your face however you should be following your specific surgeons post op instructions as he/she is the only one who knows your specific case.

	"Dr.D"

Todd C. Case, MD · Answer

You can try a temporary filler like a Hyaluronic acid product, but this would require maintenance every six months or so.  You would likely get a better long lasting result with micro-fat grafting to the tear trough.  These grafts should be placed perpendicular to the tear trough and not along the long axis of the tear trough to try to prevent "sausage-like" appearance.  Fat grafting has been to shown to improve the quality of the overlying skin as well as thicken the overlying skin which may be further benefit to you.  Also, you can try bleaching agents like 4% Hydroquinone to try to lighten the pigmentation you report, but this may provide only another temporary solution.

Steven Turkeltaub, MD · Answer

The questions that you are asking here online, you should be inquiring of your surgeon. He/she did your surgery and that physician is the one whose instructions you should be following - for numerous reasons. So ... call and get his/her specific answers.

Edwin Ishoo, MD · Answer

Typically the face is swollen and bruised for up to 2 weeks after extensive fat transfer. Some of it has to do with surgeon's technique and some with patient's physiology. Five days after surgery, warm or cold packs will have minimal effect on expediting resolution of swelling. You should follow up closely with your surgeon but in my practice we have seen good results with timely use of a brief corticosteroid taper for resolving swelling and arnica montana pills before surgery and ointment after surgery to minimize or expedite resolution of surgical ecchymosis. I would recommend being patient for a couple of weeks and keep your surgeon informed of your concerns and progress.

Steven Wallach, MD · Answer

At 5 days it is certainly normal, to have some bruising. As for the specific post treatment care protocol, you should ask your surgeon.    Every surgeon is a bit different.

Robert L. Kraft, MD, FACS · Answer

I recommend cold for swelling.  I hope that your plastic surgeon instructed you on the use of cold packs, which are very important in the 72 hours after surgery.  If you remain quite swollen, then continued cold packs can continue to be applied.   The swelling and ecchymoses (a fancy word for black and blue marks) should continue to resolve gradually.  A warm rice pack will not hurt your recovery but will not alleviate the swelling.

Swelling - Ice or Heat for Fat Transfer/Bleph?

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