Facial Surgery Recovery Questions (From Medical Tourism)

Q: Dr. Eppley,I have some facial surgery recovery questions. I’m in my early 20s. I came across your profile on RealSelf and was impressed by your experience across a vast number of procedures. I could not find any answers on the website to my problem and thought you could hopefully help me answer some questions about some recovery problems I have been experiencing. 

I underwent multiple facial procedures in Thailand and now I’m really really worried about my decision and hope you can put my mind at rest or guide me in the right direction. 

I underwent a silicone chin implant, breast fat grafting, double chin liposuction, endoscopic/intraoral cheeklift, and tiplasty. I am currently 2 weeks post-op.

(1) I had a winged silicone chin implant put in via the mouth. I believe I can feel the wing on the left side riding up so that the implant as a whole does not look symmetrical. How long should I wait before I have a revision for this if it truly is asymmetrical?

(2) My chin area is lumpy and red from the double chin liposuction. Is this normal at more than a week out or is there hope for the lumpiness to resolve further over time?

(3) My endoscopic cheeklift swelling was very extensive. Though there was no eyelid incision, my eyes blew up like balloons by day 3 and I was near-normal-but-puffy by day 6. Day 7 however took a turn for the worst. My right eye blew up again in the morning, and has stayed that way for the last couple of days. At the very outer corner of my right eye, there is a hard lump near the eye socket and a little pocket of air or fluid which is very tender. The little air/fluid pocket area is around the size of a quarter. From the 45 angle view, it is at the very top of the ogee curve and makes my cheeks look square. Could this be a possible seroma? Do I need it drained or will it go away? I’ve read that untreated, there can be consequential scar tissue and irregularities. 

I am very worried about my healing and cannot communicate with my doctor as he is overseas and I have no translator with me.

A: In answer to your facial surgery recovery questions:

1) That certainly sounds like chin implant asymmetry which is much more common when placed intraorally.

2) The contour results from submental/neck liposuction takes 8 to 12 weeks to fully realize.

3) I can not speak to your cheeklift issues since I have no idea how it was done and what lies underneath that was used to perform it…but this sounds like a possible infection.

Dr. Barry Eppley

Indianapolis, Indiana