Swollen / Puffy Cheeks & Lower Face After Forehead Lift, Midfacelift and Nose Job

I Just Look Weird,my Cheeks Are Puffed Up and the Lower Portion of my Face Swollen As Well..help! i used to have an oval shape face,now after a forehead lift,midfacelift,and nose job,the almond shape of my eyes are gone,i look part masculine and part grotesque freakishness,my nose points down,still has a hump and puffy tip,i tried sculptra for the nasal labial folds and i just look worse,chipmonkish.i am fearful to do anything else,people stare in not a good way.i look so freakish i am ashamed to see my family.my cheeks are overstuffed ,upper lip to big.please help me!

Doctor Answers 17


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i believe you feel this way but actually there is nothing"freakish" or  "wrong" with your appearance on these photos. admittedly they are a poor substitute for an actual exam but the looks you are getting may be a reflection of your own feelings.  I agree these procedures are notorious for prolonged swelling and there will be improvement over time. I mean it. having said that , stop doing stuff. don't inject any thing, don't cut any thing. give your face a rest and let it recover. good luck and remember everything gets better with a little time.

Boca Raton Plastic Surgeon

Swelling After Multiple Procedures

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Based on the pictures and your story, it's obvious that you still have a certain amount of swelling.  You may not feel happy about the way you look right now, but I can assure you are a beautiful woman and that your result is certainly not a bad one. Of the procedures you had performed, some are rejuvenative and some are transformative, in other words intended to achieve a diff rent look (Rhinoplasty and mid-face lift fit into this category).  Transformative procedures lead to a certain amount of second guessing, especially if performed in the setting of multiple additional procedures.  I would advise that you give more time for the swelling to subside, keep in close contact with your Surgeon, and avoid further cosmetic procedures until you have come to terms with the changes already made.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 104 reviews

Please take a deep breath, slow down, and try not to panic!

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What you had done is a vast amount of facial surgery.  You did not share with us how long out from surgery you are.  Judging from the lack of bruising and the fact that your swelling is pretty consolidated (please don't make me define what I mean from that), I am guessing your are at least 6-8 weeks out from this surgery.  I did not get the privilege of examining you before surgery and you did not include before photographs.  Ultimately what others think does not really matter, this business is all about your subjective feelings.  Having said that, for the surgery you have had, my subjective opinion is that this potentially an excellent result.  This does not mean that you are not swollen or that you you are done healing.  It does not mean that your family won't criticize you for trying to stay relevant as you age ( healthy families always like us the way we are).  I would recommend that you stopping trying to tweak the results and just let the face settle.  I am sure your surgeon has told you that you look fantastic.  I would absolutely agree with that assessment.  Now cosmetic surgery is a field where we are always asking how things can be better.  It may be in a year, you decide that you need further refinement.  Now is not the time.  Please give yourself permission to heal.  You look great.  Now you need to heal.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Face swollen after Face Lift and Brow Lift

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  You didn't mention how long after a Face Lift and Brow Lift these photos were taken.  It would be reasonable and expected that your face would be swollen for several months after these procedures depending on the degree of tissue undermining for the Mid Face Lift.  It would also depend on the way, the Mid Face Lift was performed.

  In traditional Mid Face Lifts, incisions are placed, inside the mouth and in the temple, the tissues of the midface and cheeks are elevated off of the bone and lifted upwards and backwards.  IMHO, this causes the corners of the mouth and eyenrows to be pulled upward, sometimes to an unaesthetic level.  If the cheek area is already full, they may look to full as the mid face tissues are pulled up onto the cheeks.  For these reasons, I do not like the Mid Face Lift and prefer other types of Face Lifts.

 From your photos, it does appear that your upper lip is larger than your lower which is out of balance with the ideal aesthetic lip shape.  IMHO, the NLF's are full and the anterior cheek area is not as round and soft as the ideal cheek shape.  These can easilly be adjusted using NLF micro-lipo, Alloderm to the lower lip and soft tissue fillers like Perlane to shape the cheeks.  Hope this helps.

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

Swelling after Surgery

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Although you didn't provide how far out you were from all procedures, from the appearance alone it seems like you are probably about a month or two postop.  You had a considerable amount of surgery, specifically in the area of the midface, referring to rhinoplasty and a midface lift.  Traditionally, both of these procedures result in moderate swelling in the mid face region which takes a number of months to subside.  Specifically with regards to midface lift surgery, the subperiosteal approach utilized, causes patients to suffer from prolonged periods of post op swelling.  At this point I would wait to see what the final results look like in 6-8 months before undergoing any thoughts of revision.  Good Luck.... Dr. Corrado

Anthony Corrado, DO
Philadelphia Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Early Anxiety in Plastic Surgery

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You will be fine.  This is swelling and recovery.  Every patient experiences this.   Go talk to you surgeon.  Follow his direction exactly.  Good Luck   Dr Commons

Swelling after forehead lift, midface lift, and rhinoplasty. Lots of surgery--lots of swelling should be expected!

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Since you don't have any more bruising (and may have not had much even initially), I must assume you are more than a few weeks after surgery. You also look quite young, and perhaps didn't really "need" all that surgery--but that is an issue between you and your chosen surgeon!

Realize that mid-face lifting usually involves subperiosteal dissection and lifting (the periosteum NEVER sags, so I have always been skeptical of this particular procedure's validity), and the resultant swelling tends to last several months, not several weeks, another reason I am not a fan of this particular type of lift. Add to that the swelling from your forehead, which tends to "go south" towards your face and neck simply from the effects of gravity, and you have a very reasonable explanation for your persistent swelling.

The good news: over time it WILL resolve, but it will take longer than you think (or want), so you have to be patient, and not go in for "other stuff" in the meantime. This means NO MORE Fillers, particularly the ones that last a long time, since your swelling will also!

Your nasal appearance will take 6-12 months to be final, but judicious steroid injection may be considered after a minimum of 2-3 months if scar tissue is the cause of any irregularity.

Be patient and give yourself the time necessary to see the full extent of your requested changes before asking for more surgery or other modification. For 7 examples of my patients undergoing multiple facial procedures and listed post-op photo dates, click the link below. Best wishes!


Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Facelift, midfacelift, brow lift, gone awry

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The first thing I notice about you, you are quite young, and where cosmetic procedures at best will reduce aging, when premature, can make you look 'different' rather than better. You have to very careful that you do not get lead into procedures such as browlift or mid facelift which can change expression or facial shape unless this is truly what you want. Seems like it is time to hold everything, rest and heal, and then take a more measured approach to small changes which you understand.
Best of luck,

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

What to Expect Following Multiple Facial Surgeries

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Throughout the #facial #healing process you should be seen frequently by your doctor and one of their registered nurses to ensure you are following instructions properly and your recovery is going well. #Recovery time varies from person to person, but patients can generally expect to be presentable within three weeks from surgery.  The healing process in general can take up to one month for the majority of swelling to subside, incisions to close, sutures to come out, and for bruising to completely go away. 

The scars mature within six to twelve months from the surgery date. It is during this time that the rejuvenating effects of the facelift and necklift will become apparent and the real result will be seen.
Patients should expect swelling, bruising, and discoloration of the skin during this phase of recovery (swelling normally goes down after 48 hours; most bruising will go away within two weeks). Some degree of firmness or lumpiness under the skin is normal after surgery and will resolve with time. Local #massage of the areas may accelerate the resolution of this problem, which normally takes 2-4 months to disappear completely.
The marks from a facelift can easily hidden with “camouflage” make-up which you can learn how to apply. If you have certain concerns about the procedures and #healing process, it is recommended to call your board-certified surgeon or their medical staff and discuss those #concerns.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Swelling After Facelift

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It appears that you still have some swelling. This swelling will subside, generally within a year. In the meantime, please wait until then before considering other treatments. Best of luck.

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.