You've probably noticed it if you've been binge-watching Chicago P.D. lately. One season Adam Ruzek looks like the scrappy, thin-faced rookie we met years ago, and the next, his face seems... different. Thicker. Maybe a bit swollen. It’s the kind of thing that makes you pause the TV and head straight to Reddit. Naturally, the Patrick Flueger plastic surgery rumors started flying. People love a good "filler gone wrong" theory, but the reality is usually way more complicated than just a trip to a Beverly Hills clinic.
The internet can be a mean place. When a celebrity’s appearance shifts, the first instinct is to scream "Botox!" or "Fillers!" Honestly, though, looking at Patrick Flueger over the last few seasons of Chicago P.D., there is a lot more at play than just cosmetic tweaks. Between aging, weight fluctuations, and some pretty intense personal health rumors, the story isn't just about a needle.
The Mystery of the Puffy Face
Around Season 6 and 7, fans started getting vocal. Ruzek’s jawline didn't look as sharp. His cheeks looked "puffy." Some fans even coined the term "moon face" to describe the change. In the world of cosmetic procedures, that usually points to fillers—specifically in the cheeks and lips. If you overdo it with Voluma or Juvederm, you get that "chipmunk" look where the eyes start to look squinty because the cheeks are pushing upward.
But here is the thing: plastic surgery isn't the only thing that causes a face to round out.
There has been a lot of talk among the One Chicago fanbase about potential health issues. One common theory is that Flueger might have been dealing with an autoimmune condition. Why does that matter? Because the treatment for many autoimmune flare-ups involves high-dose steroids like Prednisone.
Steroids are notorious for causing "moon face"—a literal medical term for facial swelling and fat redistribution. If you've ever been on them, you know. Your face gets round, your neck gets thicker, and you look like a totally different person in photos. It’s not a choice; it’s a side effect of trying to get healthy.
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Aging in the Public Eye
We also have to talk about the "Zac Efron effect." Men’s faces change as they hit their 40s. Patrick Flueger is 41 now. He isn't the 20-something kid with the red hair from The Princess Diaries anymore. When men age, their faces often widen. If you add a bit of "relationship weight" or just a change in fitness routine, it shows up in the face first for some guys.
- Weight Gain: He definitely filled out muscle-wise over the years.
- The Beard: A thick beard can hide a jawline or make a face look much wider than it actually is.
- Hairline: There’s also been talk of a hair transplant. In early seasons, his hair was thinning a bit; now it’s thick and luscious. That’s a common "procedure" for actors, but it’s a far cry from a full face-lift.
That 2025 Hiatus and the Personal Struggles
Things got even more intense recently. In late 2025, news broke that Patrick Flueger was taking an unexpected leave of absence from Chicago P.D. due to "personal matters." This sent the rumor mill into overdrive. Some reports, including those from industry insiders like Deadline, hinted at a difficult period in his personal life.
When an actor disappears and then comes back looking slightly different, people assume they went away to "get work done." But the timeline doesn't really fit a surgical recovery. He was back on set by December 2025, celebrating his birthday with co-star Marina Squerciati. He looked happy, healthy, and—importantly—like himself.
The "personal reasons" for his hiatus were never officially confirmed as health-related, but the physical changes fans noticed over the years align more with lifestyle and health fluctuations than a surgeon's scalpel.
Patrick Flueger Plastic Surgery: The Expert Take
If you ask a plastic surgeon to look at his photos, they’ll give you a "maybe."
Could he have had a little Botox to smooth out the forehead? Sure. Most actors in Chicago or LA do. It’s basically a job requirement at this point. Could he have tried a bit of filler? Possibly. But the dramatic "puffy" look many people pointed to looks much more like systemic swelling (think salt, alcohol, or medication) rather than the localized, structured look of cheek implants or filler.
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The most likely scenario is a combination of things:
- Natural aging and the loss of "baby fat."
- Possible medication side effects that caused temporary puffiness.
- Lifestyle changes that affected his weight.
Honestly, we’ve seen this before with actors who are under a lot of stress or working 14-hour days on a gritty police procedural. Your body takes a beating.
Why It Matters to Fans
People get protective of their favorite characters. We’ve spent over a decade with Adam Ruzek. When he looks "off," we worry. But the obsession with Patrick Flueger plastic surgery often ignores the human element. Actors are allowed to age. They’re allowed to have health issues that make them look a bit bloated for a season or two.
If you look at the most recent footage of him from late 2025 and early 2026, he looks great. The puffiness seems to have subsided, which actually supports the "medication" or "lifestyle" theory over the "permanent surgery" theory. If it were surgery, it wouldn't just go away.
What to Watch For Next
As Chicago P.D. moves through 2026, keep an eye on how Ruzek is filmed. Directors often use specific lighting or angles to hide swelling if an actor is going through a health "thing." But for now, the consensus is shifting away from the plastic surgery narrative.
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If you’re concerned about your own facial changes or wondering if "the work" is right for you, it’s always better to look at the root cause. Sometimes a change in diet or a check-up with a doctor is more effective than a filler appointment. For Patrick, it seems like he’s weathered the storm and is back to being the Ruzek we know and love.
To stay informed on his return to the screen, you can check out the latest production updates from NBC or follow his co-stars' social media, as they often post behind-the-scenes clips that show the "real" Patrick without the TV makeup and filters.