Correct Bad Fat Transfer Results with Blepharoplasty?

asked 3 years ago by luls7 in Toronto, Canada
Latest answer by Boris Volshteyn, MD, MS
Question viewed 7,294 times
Tags: under eyes, complication, lumps, swelling

I had a fat transfer under my eyes because they were so hollow. Around 6 months later, there was an uneven swelling that hardened into uneven lumps. It made me look like I had pouches. So I went back to the surgeon who suggested that the best correction to resolve this was to perform a full blepharoplasty. This was 2 days ago and am panicking about what I have done to myself. Was this a bad choice? What options do I have for correcting this?

11 answers to Correct Bad Fat Transfer Results with Blepharoplasty?

Caution!

If your surgery was six months ago and things have reached a plateau, it is likely that you have a stable problem. The problem is how to treat it. Firm lumpiness from fat injection to the lower eyelids is a common problem. In my experience it is usually necessary to remove the fat injection lumps directly. This is a tricky proposition, to say the least, because the lumps can be in all layers of the lower eyelid, from the epiperiosteal layer to the shallow subcutaneous layer, with the... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

www.drbrent.com

You may need to look at other options.

I think Dr. Wallach thought your surgery was two days previous and if that were the case I completely agree with his assessment. However, if you had fat transfer 6 months ago then you may have issues with the fat not surviving or scar tissue forming where the fat transfer was attempted. The lower lid and area below the lids is one of the more delicate places on your body and small amount of tissue can make a big difference. When I was in training at Yale University, we had a... more

Steven H. Williams, MD
San Francisco Plastic Surgeon

Blepharoplasty after Fat grafting

Dealing with complications of plastic surgery is never easy. It is frustrating, disappointing and worrisome. Unfortunately, even in the best of the hands, it is a way of life. Lumpiness and bumpiness, skin irregularity and some thickening after fat grafting is normal. Usually, with massage and occasional steroid injections these problems can be managed well. Unfortunately, sometimes, more aggressive approach is needed. The area of the lower eyelid and its junction with the... more

Boris Volshteyn, MD, MS
Reno Plastic Surgeon

There are other ways to help this issue

Lumps and Bumps can happen without almost anything that you do when you manipulate the tissues. When they are around the eyes, it's pretty hard to mask their appearance. I can appreciate the concerns. There are many things that can be done to help this. First, steroid injections can help by causing some of the fat to be dissolved by the body through the action of the steroids. There are risks with the use of steroids so you should be aware of these before undergoing these injections. ... more

Philip Young, MD
Bellevue Facial Plastic Surgeon

www.drphilipyoung.com

Correction of lower eyelid nodules after fat transfer

Fat transfer is a well established method of restoring volume to the face. The amount of fat survival depends on technique of harvest and injection. Technical considerations may affect volume loss, symmetry, and need for further revision. The advice of your surgeon on the fat transfer should be heeded. Nodules arising from fat necrosis may ultimately subside or may remain permanently. If your surgeon believes they will remain permanently, the best option may be to surgically excise the... more

Raffy Karamanoukian, MD
Los Angeles Plastic Surgeon

Relax, Turn Off Your Computer, and Be Patient

Hi Luis, Sorry to hear about your ordeal. I can imagine how scared and anxious you must be. The most important thing for you to do now is to follow your post-operative instructions and stay in close touch with your treating surgeon. Panicking and searching the web two days after eye lid surgery will not help in your recovery at all. There is nothing to do at this point but heal as well as you can. Your surgeon should be able to tell you how he/she feels the operation went. As you... more

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon

Hang in there

It is difficult to fill in the area under the eyes. Many people choose to have fat injected in the hollows under the eyelids. This is appealing because it has the chance of being a "permanent" correction. The problem is that fat is living tissue. In order for it to last it needs a good blood supply. That usually is not a problem around the eyes. However if any portion of fat does not stay completely healthy, with a good blood supply, it either shrinks or becomes firm. If... more

Marc Cohen, MD
Philadelphia Oculoplastic Surgeon

2 days is not enough to evaluate any surgery

At this point, I would wait. 2 days after any surgery is not a good time to evaluate the results, especially with blepharoplasty surgery. From what you describe, it sounds like you had appropriate treatments. I would wait at least a month, and sometimes several months, before determining the success or failure of the treatment.

D.J. Verret, MD
Dallas Facial Plastic Surgeon

The eyes have it again

Luls, Lumpiness can occur in the lower lid tear trough area after fat injection to correct hollowing. Removal may require a surgical procedure such as blepharoplasty, done through a transconjunctival (inside the eyelid) or skin incision approach depending on the depth of the fat injected. This would be the most effective way of addressing the problem. Don't lose hope. You may still have a very happy ending. Good luck!

Kenneth R. Francis, MD
Manhattan Plastic Surgeon

Wait it out

The firmness from after the fat injections to the lower lids was the fat that was injected. The skin of the lower lids is very thin and unfortunately, sometimes the grafts become palpable. I can't answer you about whether or not you made a mistake to have undergone bleph 2 days ago, because I don't know what you started out needing. Now, all you can do is wait it out and heal and see how things turn out. Steven Wallach, MD

Steven Wallach, MD
Manhattan Plastic Surgeon

Transconjunctival blepharoplasty is an excellent way to correct eyelid lumps after fat transfer

It sounds as though you have had the correct procedure and that your surgeon knows what he/she is doing. Try to relax and be patient and follow your doctors advice. It is normal to wrry and be concerned. But you made a decision, it sounds as though the correct procedure was done. Worry will not help--it will only make your recovery more difficult. Try to be patient and relax.