POSTED UNDER Facelift Reviews
Expensive Revision Surgery After Cosmetic Surgery Complications
ORIGINAL POST
Expensive Revision Surgery After Cosmetic Surgery Complications
I chose Dr. Miranda for a facelift procedure in December with the goal of addressing 3 areas 1) neck and jaw laxity, 2) nasolabial folds that were becoming more prominent as I aged, and 3) fat loss in my cheek and temple areas. I also had CO2 laser resurfacing while under anesthesia. This is where things stand nine months later.
The neck and jaw lift came out fantastic. As his office manager said, it looks “snatched.” I agree. If everything had been to this level of outcome, I would be thrilled and you would be reading a 5-star review.
The facelift, not so much. The folds look worse than before surgery, both in overall prominence and because I now have a strange pouch in my cheek. I'm still hoping some or all of it is residual swelling, but even if the pouch goes away, I don't expect the folds to be improved from before surgery.
At 6 months I sent a picture of my cheek taken at a work event because it captured my concern very well, and asked whether the issue was residual swelling or something I should be concerned about. The response was that “it is mostly attributable to harsh overhead lighting as the skin integrity and quality all along the jawline and neck look very good.” No acknowledgment of the swelling at all. When I later asked Dr. Miranda about it in person, about whether it's swelling, I didn't get an answer. He didn't even get close and look at it or touch it to see if it was edema. He said he could go in and pull the cheek up further.
The big issue, however, was the fat graft. Within weeks of surgery, it became apparent that I had a large lump in the right orbital area . Dr. Miranda's verbal response was, “that's not from me.” He said he hadn't gone into the orbital area and repeatedly described it as a “festoon,” and suggesting that if it was fat, it had come from somewhere else, not his procedure. It was early, so all I could do was wait and hope it would improve. In the mean time, I looked weird and it just got worse.
At four months, as the overall swelling subsided, “pearls” of fat emerged ton my right side, visibly protruding along my cheekbone.
We talked about what to do with the pearls. Dr. Miranda was still describing the right side as a “festoon.” He proposed using a cannula on that side to remove whatever was there and, if he couldn't get to it, going in from above, and going in through the lid on the other side (basically a bleph) to remove the pearls.
The cannula approach didn't make sense to me. I couldn't understand how suctioning the area was going to produce a smooth cosmetic result. The goal isn't a "fix" it's a "make it look better. I was also concerned about the festoon narrative and wanted to hear what other doctors thought.
As an aside, it's surprisingly hard to find a surgeon willing to fix another surgeon's work. I had multiple consulted, most of whom did not want to touch it. Every one of them told me that what we were seeing on both sides were absolutely grafted fat and advised me against the cannula approach.
Fortunately, I found a fantastic oculofacial plastic surgeon, who performed a lower lid bleph (I had had one before this, so this was a redo from the facelift), removed the lumps and filled the divots that the removed fat created. His operative report states that the fat was “superficial to the orbicularis muscle.” In layman's terms, the grafted fat was between the muscle and skin rather than at the level where it could establish the blood supply it needed to survive. It necrotized, meaning it died, which is why I had these large lumps in my face.
The “Cheetos” photo below shows what came out of my face during the revision.
Post-revision, I finally look "normal" howver I still have one lump left. I now have to decide whether to undergo another surgery , have it removed through an incision in my face and live with a scar, or walk around with a prominent lump in my cheek. None are great options. This whole thing has been a time-consuming, expensive and emotionally brutal experience.
Everyone knows to assess artistry and surgical skill when choosing a surgeon. But you're also choosing the person who will guide you through a major surgery and recovery. If everything goes perfectly and you have no questions, communication may not matter much. When it doesn't, you want a provider who communicates clearly, answers questions and partners with you on what to do next. I found it very difficult to get clear answers even to basic questions about whether things were tracking normally and what to expect.
Things go wrong. Choose a doctor who is going to be in the trenches with you when they do, not watching from the sidelines or ducking for cover. It’s amazing how much a simple acknowledgment and open collaboration can accomplish. Next time, I will choose differently.
The neck and jaw lift came out fantastic. As his office manager said, it looks “snatched.” I agree. If everything had been to this level of outcome, I would be thrilled and you would be reading a 5-star review.
The facelift, not so much. The folds look worse than before surgery, both in overall prominence and because I now have a strange pouch in my cheek. I'm still hoping some or all of it is residual swelling, but even if the pouch goes away, I don't expect the folds to be improved from before surgery.
At 6 months I sent a picture of my cheek taken at a work event because it captured my concern very well, and asked whether the issue was residual swelling or something I should be concerned about. The response was that “it is mostly attributable to harsh overhead lighting as the skin integrity and quality all along the jawline and neck look very good.” No acknowledgment of the swelling at all. When I later asked Dr. Miranda about it in person, about whether it's swelling, I didn't get an answer. He didn't even get close and look at it or touch it to see if it was edema. He said he could go in and pull the cheek up further.
The big issue, however, was the fat graft. Within weeks of surgery, it became apparent that I had a large lump in the right orbital area . Dr. Miranda's verbal response was, “that's not from me.” He said he hadn't gone into the orbital area and repeatedly described it as a “festoon,” and suggesting that if it was fat, it had come from somewhere else, not his procedure. It was early, so all I could do was wait and hope it would improve. In the mean time, I looked weird and it just got worse.
At four months, as the overall swelling subsided, “pearls” of fat emerged ton my right side, visibly protruding along my cheekbone.
We talked about what to do with the pearls. Dr. Miranda was still describing the right side as a “festoon.” He proposed using a cannula on that side to remove whatever was there and, if he couldn't get to it, going in from above, and going in through the lid on the other side (basically a bleph) to remove the pearls.
The cannula approach didn't make sense to me. I couldn't understand how suctioning the area was going to produce a smooth cosmetic result. The goal isn't a "fix" it's a "make it look better. I was also concerned about the festoon narrative and wanted to hear what other doctors thought.
As an aside, it's surprisingly hard to find a surgeon willing to fix another surgeon's work. I had multiple consulted, most of whom did not want to touch it. Every one of them told me that what we were seeing on both sides were absolutely grafted fat and advised me against the cannula approach.
Fortunately, I found a fantastic oculofacial plastic surgeon, who performed a lower lid bleph (I had had one before this, so this was a redo from the facelift), removed the lumps and filled the divots that the removed fat created. His operative report states that the fat was “superficial to the orbicularis muscle.” In layman's terms, the grafted fat was between the muscle and skin rather than at the level where it could establish the blood supply it needed to survive. It necrotized, meaning it died, which is why I had these large lumps in my face.
The “Cheetos” photo below shows what came out of my face during the revision.
Post-revision, I finally look "normal" howver I still have one lump left. I now have to decide whether to undergo another surgery , have it removed through an incision in my face and live with a scar, or walk around with a prominent lump in my cheek. None are great options. This whole thing has been a time-consuming, expensive and emotionally brutal experience.
Everyone knows to assess artistry and surgical skill when choosing a surgeon. But you're also choosing the person who will guide you through a major surgery and recovery. If everything goes perfectly and you have no questions, communication may not matter much. When it doesn't, you want a provider who communicates clearly, answers questions and partners with you on what to do next. I found it very difficult to get clear answers even to basic questions about whether things were tracking normally and what to expect.
Things go wrong. Choose a doctor who is going to be in the trenches with you when they do, not watching from the sidelines or ducking for cover. It’s amazing how much a simple acknowledgment and open collaboration can accomplish. Next time, I will choose differently.
Gentle159969's provider
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