Swelling - Ice or Heat for Fat Transfer/Bleph?

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.

Doctor Answers 13

Swelling after fat transfer

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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.

Cambridge Facial Plastic Surgeon

Cold, not hot, for swelling

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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 will go away

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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.

Blepharoplasty Swelling

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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

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 103 reviews


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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.


Edward E. Dickerson, IV, MD
Fayetteville Facial Plastic Surgeon
4.7 out of 5 stars 127 reviews

Decreasing swelling after Blepharoplasty and Facial Fat Transfer

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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.

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.6 out of 5 stars 17 reviews

Tear trough problem post blepharoplasty

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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.

Todd C. Case, MD
Tucson Plastic Surgeon

Ice or Heat for Post-op Swelling

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It is not uncommon to experience swelling 5 days after an upper/lower eyelid blepharoplasty and a full face fat transfer. I tell my patients to use ice to decrease this fullness and accelerate the resolution of the normal, temporary swelling. The most important thing you can do at this time is to contact your surgeon for instructions.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Treatment of facial swelling after fat transfer

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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.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.7 out of 5 stars 33 reviews

Swelling - Ice or Heat for Fat Transfer/Bleph?

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IMHO, you should call and ask the plastic and cosmetic surgeon, that did your procedures, these questions and follow his/her post op instructions.  It's unethical for another surgeon to give you specific post op advice during the acute post surgical stage when your are under the care of another surgeon.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 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.