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David Shafer, 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.


David Shafer, MD
12 months ago
By David Shafer, MD - Manhattan Plastic Surgeon

With fat grafting or any procedure, it is possible for you to develop "lumps," especially if you are being injected by an inexperienced injector. However, now that you have a lump it is best to wait some time before jumping into additional operations or procedures. These additional procedures are not without their own risk. It is important to seek the opinion of your surgeon and, possibly, other surgeons as you have. With out examining you myself, it is hard to give you specific advice. However, if you have seen 5 other surgeons and no one is suggesting an intervention at this time, I would tend to trust their advice. If you can find someone that says they will intervene, that may not be the correct answer. Most of these things improve with time, but I know that waiting is very difficult. Good luck.

David Shafer, MD
Shafer Plastic Surgery

Web reference: http://www.RealCosmeticSurgery.com
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More answers to “Tear trough area lump after fat transfer”

A: Sounds like a cyst or irregular placement of injections

Robert M. Freund, MD
12 months ago
By Robert M. Freund, MD - New York City Plastic Surgeon

Fat should have the same texture and softness as the underlying fat. This is different than other fillers which are typically harder, and appear harder when you smile. Your description of seeing the lumps only when you smile suggests that the material is harder than the surrounding tissue. This could be swelling or a localized cyst. If it is just swelling then wait, if it is a cyst then surgical removal may be in your future. If you have the lump at all times, perhaps you need more filler.

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A: There may be options

Steven Wallach, MD
12 months ago
By Steven Wallach, MD - Manhattan Plastic Surgeon

Without examining you, I can not specifically comment on your case. This could be the fat itself or scar tissue. However, direct excision of the lump may be possible. One colleague even reported that if it is smalle enough, he will often "pinch" it with surgical tweezers and it helps break it up.

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