Facial Swelling after Custom Infraorbital-Malar and Jawline Implant Surgery

Q: Dr. Eppley, I am two days after custom infraorbital-malar and jawline implants. I’m feeling OK, pain is tolerable. However I have significant facial swelling, right face greater than left (I notice that this is far more than what I had my Lefort 1 surgeries).

I have started medrol dose pack. Is this common to see this amount of swelling? Is there anything else that needs to be done? Should I take the bandage off?

A: Your surgery went superbly and your lower eyelids did not have to be disturbed from above. Coincidentally I also drained a large sebaceous cyst in the left cheek area the became more revealed from the perioral liposuction.

What is important to remember about the facial swelling is the following:

1) It will be considerably more than anything you have ever seen before. If you think about it your entire face was degloved off the facial bones with the exception of the nose. That is not remotely similar to anything you have ever experienced previously. So even though you may have been partially ‘prepared’ from our prior surgeries, that is the barometer by which to judge the swelling from this surgery.

2) Swelling will takes 2 days to maximize. So whatever we see today will be worse by tomorrow, this is normal. I would basically expect your face to look like a round pumpkin by tomorrow at the peak day. It is psychologically disturbing, as I mentioned before surgery, and it will take about1days until you feel better by the direction that things are heading….but a good month until things start to look close to what the final facial reshaping effect will be.

3) Even though the surgery was done symmetrically, the same things to both sides, they never swell symmetrically. One side will always swelling more than the other.This is normal.

You may remove the chin strap at any time. It is only there if it provides comfort. It has no role in stabilizing the position of the implants.

You may shower and wash your hair today as normal.

Despite all the thought that goes into these surgeries, this early recovery phase is the hardest for patients as only time, healing and patience are the ingredients for recovery.

Dr. Barry Eppley 

Indianapolis, Indiana