Q: I had a facelift four months ago and am generally pleased; but I have a significant lump below each cheekbone that is very obvious when I smile. It isn’t tender, but is very firm and hasn’t improved with regular massage for several months. Is this permanent?
A: Most of the time, scar production peaks in thickness, lumpiness, swelling, redness and irregularity in 12 weeks (3 months) and has subsided by 6 months. Another 6 months or more of scar remodeling occurs to breakdown the thick, lumpy scar into the smooth, thin sheet or line scar we desire.
It is best to direct this question to your surgeon. If he used dissolving sutures, this will flatten in time. If this is another issue, he / she may address it differently. Since it appears to be similar on both sides of your cheek, it is my impression that this is the knot of the suture for your SMAS lift and like mine, will dissolve and flatten.
Massage and patience will help.
All the best!