Swelling or Malar Bags After Facelift?

Question

Female, 38. Had a mid anterior face lift and a lower lid pinch bleph (no fat removed just small amount of skin). I am 8 weeks post surgery. I still have pockets of swelling on the bottom of my lower lids right lid worse, edema settled in the dreaded malar area. My surgeon said these are not malar bags and that the swelling will dissipate in time. I am now getting worried that this swelling will not go down. It looks worse under light, like malar bags. Will it go?How long do you reckon?! Thanku!!

Stephen Weber MD, FACS · Answer

Significant swelling can result from midface lifting. From your description this seems to be one of the procedures that you've undergone. You have healed enough that massage will likely be of benefit to you. I recommend massaging both cheeks in circular motion while lifting the cheeks in an upward direction. This will support the desired tissue movement from the midface lift and help reduce the edema that you're likely experiencing. Try to be patient as you need time to heal. I would withhold judgement for several months until your swelling has completely resolved.Stephen Weber MD, FACS

Young R. Cho, MD, PhD · Answer

Thank you for your question for sharing your concerns with us. Swelling and firmness in the tissues will return to normal as time passes by. Between the first and second week, much of your swelling and bruising will dissipate. It may take more than a month or two for your tissues to fully soften and any residual swelling to resolve. Lymphatic massage maybe an option to help clear the swelling and firmness at a faster pace.  I would make sure that you continue to follow up with your plastic surgeon during this period of time.

Rafael C. Cabrera, MD · Answer

massage, massage, massage and tincture of time. remember surgery is like making an omelette, you have to break some eggs, but its worth it. hang in there, 12 weeks minimum.

Steven Wallach, MD · Answer

Sometimes patients have malar edema and do not appreciate it until after surgery.  At eight weeks swelling can be persistent give it more time to resolve.

Brooke R. Seckel, MD, FACS (retired) · Answer

Check your pre op photos. Malar bags are never caused by surgery. If you had swelling below the eyelids on the cheek bone you may have had malar bags which have now been made more obvious by the Blepharoplasty. This certainly does happen not infrequently but usually only after eyelid fat is removed during lower eyelid Blepharoplasty-which was not the case for you.

	If there was no puffiness or swelling below the eyelid on the cheek bone before surgery then the swelling is most likely post operative edema and swelling and will go away with time. Ask your doctor if it is OK to massage the swelling pushing out towards ear. This can help speed the reduction of swelling

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