It is best to takes a stepwise approach

Amir M. Karam, MD answers: Tear trough area lump after fat transfer

I had fat transfer done in April 2008, and after two weeks, a visible lump formed on my right cheek and a larger bulge on my left side, but it's visible only when I'm smiling and laughing. Since then I seeked the advice of 5 other doctors, all unwilling to touch my face, all telling me different times (from 6 months to 3 years) to wait it off. What can I do besides waiting for months or years "to see" if it will go away? Can I get a proactive approach to a solution instead? Thank you so much.


Amir M. Karam, MD
9 months ago

Without examining you or looking at a photo, it is hard to give you sound advice. But, the first step is to find an experienced fat transfer surgeon who performs many treatments around the eyes. As a general conservative approach, the first step is often direct micro-aspiration during the early phases (i.e. within a month). The fat is still soft and can potentially by suctioned out. This can be coupled with massage, but massage alone rarely treats the problem completely unless it is subtle.

Next step would be to inject the fat with a very dilute steroid. Often this will take several treatments. This is a delicate area so it is important the injections are done very conservatively and placed in the correct levels to avoid complications. Unfortunately, if the lumps are because of too much fat placed into a given area which resulted in a raised lump, many times it will require a direct excision through a small skin incision. Depending on the location, it can be done through a blepharoplasty incision, but often times, a direct incision over the lump is more effective. But if the size is diminishing with time, then I would certainly advice waiting it out.

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