San Francisco Fat Transfer doctors

	Steven H. Williams, MD San Francisco Plastic Surgeon 4000 Dublin Blvd Suite 300, Dublin		14 answers
	George Commons, MD Palo Alto Plastic Surgeon 1515 El Camino Real Suite C, Palo Alto		8 answers
	Vincent D. Lepore, MD San Jose Plastic Surgeon 2581 Samaritan Drive Suite 102, San Jose		7 answers
	Daryl K. Hoffman, MD Los Gatos Plastic Surgeon 805 El Camino Real Suite A, Palo Alto		6 answers
	Scott W. Mosser, MD San Francisco Plastic Surgeon 450 Sutter St. Suite 1400, San Francisco		5 answers
	Kimberly Lee, MD Beverly Hills Facial Plastic Surgeon 433 North Camden Drive Suite 780, Beverly Hills		2 answers
	Stephen J Ronan, MD San Francisco Plastic Surgeon 3600 Blackhawk Plaza Circle, Danville		2 answers

Recent Answers

After 15 Years Fat Injections to my Tear Troughs Are Still Lumpy and Look over Corrected. Do I Have Options for Removal? After 15 Years Fat Injections to my Tear Troughs Are Still Lumpy and Look over Corrected. I Have Been Told by 4 Top NYC plastic surgeons they cannot remove it or minimize it...With new technology, I am not sure why it can't be reduced with laser or some kind of injection... At 55 finally I am losing more of my own fat around the injections sites and the lumps are becoming more prominent. Three years ago I had a surgeon inject filler around the lumps to try to even out the area with some success but now the filler is gone and the area looks worse...Help!

A: Fat in tear troughs

Thanks for your question -

Fat injection in the tear troughs can cause contour deformity - exactly what you're describing. The issue with fat transfer here is that the skin in this area is very thin and the distance between the skin and the bone is relatively short. This means that injection contour can sometimes be seen through the skin.

Sometimes this fat can be directly excised as part of a lower lid blepharoplasty or through micro liposuction to try to debulk the area. Typically more injections don't make things better.

Find experts in the area. Syd Coleman has a great deal of experience in facial fat grafting and would be a useful consultation. Good luck!

Steven H. Williams, MD

San Francisco Plastic Surgeon

Why is Fat Transfer a Low Rated Procedure on RealSelf? Fat transfer or grafting has slid into one of the lowest rated plastic surgery procedures on RealSelf. Under 40% of consumers say fat transfer was "Worth it". Why is this the case? Is there something wrong with the procedure, patient selection, doctor technique?

A: Fat transfer is a process, not a single procedure.

I think fat transfer is low rated because patients do not understand that it is not a single operation but is rather an ongoing process of possible several to many operations. Fat is a weak flimsy tissue and 50% of the time does not survive the transfer process. Yes, 50%. Hopefully this is explained to patients because a lack of understanding this could lead to unhappiness. I have done over a thousand fat transfer operations and doctor and patient must be happy with 50%. Like any filler, fat is lost, but the good news is 50% survives. Then another fat transfer procedure is needed and then possibly another. We must all understand fat transfer is an on going process. Even a year or two or five later more fat may be needed from time to time. Look at the bright side. All the other fillers disappear 100%. I strongly suspect that the disappointment is a result of a breakdown in communication between the patient and the doctor. Fat transfer is a fine procedure but it is what it is and nothing more. Remember, 50% I think a fair statement is that 99% of fat transfer patients need 2nd, 3rd, and 4th procedures or more. Not understanding this is the cause of the LOW RATING for a quite reasonable procedure . Best, Dr Commons

George Commons, MD

Palo Alto Plastic Surgeon

Can Fat Injected in to the Face Start to Disburse As Early As 2 Weeks? I had fat injected into my face,when the swelling started to go down around 12 days I noticed a crease below my left eye top of cheek, it looks like the surgeon missed that area, it got worse the more the swelling went down. I have always been told fat takes approx 6 months to disburse? the rest of my face forehead, right cheek etc looks ok.

A: Fat Transfer Post Operative Course

After fat transfer you really do not know where you are till about 4 months. Of all fat transferred, 50% will not survive. The rest does fine. This is a general guideline and the % may vary widely. At two weeks you are losing swelling mostly and not fat yet. I tell patients fat transfer is not a single procedure but a process of multiple procedure. The number varies from patient to patient. Fat transfer is wonderful but it is far far from an exact science. Some always survives but regardless of the technique it is often a series of treatments. Best Dr Commons

George Commons, MD

Palo Alto Plastic Surgeon