Excision of Fat Graft Overfill?

I had fat grafting to my cheeks approxmiately 2 years ago which ended up a bad case of overfill. I believe there are 4 ways to handle this situation : steroids, microliposuction, excision, and a lower facelift. I wanted to learn a little more about excision (if applicable to the cheek area). For example, would the incisions be placed inside the mouth? I want to gain a general understanding of this approach (applications and benefits vs. risks/complications). Many thanks for your comments.

Doctor Answers 8

Removal of Fat Grafting Overfill

      Incisions can be made in many areas to disguise or minimize scarring.  The other methods may be appropriate as well depending upon fat graft location and abundance.  If you did not need a lower facelift before you probably do not need one now  and the scars may be too much of a burden.  Find the plastic surgeon with ELITE credentials who performs fat grafting procedures and revisions on a regular basis.  Kenneth Hughes, MD Los Angeles, CA

Los Angeles Plastic Surgeon
5.0 out of 5 stars 334 reviews

435 North Roxbury Drive
Beverly Hills, CA 90210

Fat injections

Dear genmod,

  • Your concerns are valid, and there are different ways to handle it
  • It all depends on what your exam looks like and what your goal look is
  • When you are ready, seek out a consultation with a fat transfer specialist


Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 51 reviews

201 South Lasky Drive
Beverly Hills, CA 90212

Excision of Fat Graft Overfill

I would agree that, in general, the only directed ways to remove excess fat, regardless of its origin, is via liposuction or direct excision.  (Injecting a substance that "melts" fat may be an option at some point if there is an FDA-approved targeted material that does not diffuse to too great a degree).  Lipo can be done using any of a variety of techniques, including those that help "melt" that fat (such as ultrasonic or laser-assisted).  If it's a small amount then lipo is probably the best approach and it has the advantage of being easier to "feather" the edges.  A larger amount may require direct excision.  Either of these can be done at the time of a facelift though that is not typically enough of a reason to do a facelift (which remains a procedure that lifts and tightens tissues of the face).

I hope that this helps and good luck,

Dr. E

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 74 reviews

122 East 64th Street
New York, NY 10065

Removal of fat overfill

Removal of the fat can be done through the same access points where the fat was injected using microcannulas. Although excision is an option, this can be tricky as the fat to be removed will have to be feathered into the surrounding areas so as not to create another contour deformity.  I agree with the other surgeons that alluded to doing an open excision if something else was to be done, but not for the fat removal alone.

Good Luck


Robert Kratschmer, MD

Robert Kratschmer, MD
Houston Plastic Surgeon
4.5 out of 5 stars 17 reviews

11200 Broadway St.
Pearland, TX 77584

Cheek Fat Reduction From Fat Injection Overfill

If removal of fat from overfilled cheeks is to be performed by direct excison, the approach would have to be through some form of a facelift incisional approach. While this can be done, that seems like a big effort is that is the only objective. Liposuction using small cannula through a stab incision inside the corner of the mouth would be easier to undergo and likely to be just as effective as open excision.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.5 out of 5 stars 53 reviews

Indiana University Health North Hospital
Carmel, IN 46032

Photos would be helpful

Depending on where the actual overfill is anatomically, different approaches may be ideal. On the eyelids direct incision would be helpful. If its elsewhere and its a small focal region, once could attempt steroid injection, and then microliposuction. If its a large contour irregularity, and you are good candidate for a facelift, then this gives excellent exposure, but I wouldn't use this approach just to deal with the fat.

Posting a photo would be helpful

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 28 reviews

1110 112th Ave NE
Bellevue, WA 98004

Excision is often performed when micro-liposuction cannot be done


Thank you for the question.  It is preferable to remove excess fat through micro-liposuction as opposed direct excision since the fat can be contoured better, the incision is very small, and there is less risk of complications such as nerve or muscle injury.  There are times however that liposuction cannot be performed safely or adequately such as in the lower and upper eyelid areas.  In these areas direct excision is often the safest ways to removed excess fat.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 127 reviews

8900 E Raintree Rd
Scottsdale, AZ 85260

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