Filler for Atrophied Butt Caused Kenalog Injection?

Hi! I have had an atrophy caused by a Kenalog shot in my left buttock. I am very upset and frightened about it. Do you think it will come back on its own? If I get it filled, which filler do you recommend?

I have heard lots of stories about Sculptra forming little lumps and iI don't want to look any worse, would collagen be best? Thank you for your time. I wish I had never had this done although I have had many over the years and this has never happened before.

Doctor Answers (8)

Injections for buttock contour problems after Kenalog injection

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First of all be sure to give it a few months to be sure that the effect of the injection have fully resolved.  Although you body may heal it a bit over time typically fat grafting is the best option and likely the most cost effective.  It will take many cc's up to an ounce or two of fat to fill the area adequately and any "Filler in a bottle" is going to be expensive and likely not last as long.


Englewood Plastic Surgeon
5.0 out of 5 stars 8 reviews

Your own fat is the best filler in this case

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I would stay away from injecting any type of foreign substance into your buttocks. The rejuvenating power of your own adipose fat may be your best resource. However, you need to be examined to advise further.

The terms fat injection, fat transfer, and fat grafting all refer to the process of taking fat from your stomach area (or another area) and re-injecting it into your another area. The exciting part is this . . .

Plastic surgeons can process the fat into stem cell enriched fat cells and reinject them into another area, including breasts and buttocks. They not only rejuvenate the skin, but they can also repair damaged tissue. Stem cells are the new frontier of plastic surgery. Instead of the surgeon using his talents to create the illusion of a more youthful body, the surgeon guides your body to rejuvenate itself!!  Read more about it in the web reference and see me talk about it in the video.

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 40 reviews

Fat would be your best filler in this case

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I would recommend using your own fat to fill the hollow caused by the kenalog injections.  The fat transfer could be done under local anesthesia in the office.  Your hollow will not fill itself over time and will only be corrected by adding a filler like fat. 

Sculptra is an option, but is likely more expensive than fat in the long run, as it's not permanent.  Collagen only lasts a few months, so it's not a good option either.

Carmen Kavali, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 18 reviews

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Butt deformities can be corrected by fat grafts

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Steroid injections such as kenalog can result in depressions and contour deformities in the buttocks. Fat transfer to fill the deformities after the scar tissue is released, usually gives an excellent result and is long lasting.

Jaime Perez, MD
Tampa Plastic Surgeon
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Fat transfer for correction of corticosteroid (Kenolog) induced buttock contour deformity

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Hello Dooby,  Corticosteroid injection, such as Kenolog, can result in atrophy of the subcutaneous fat of the injection site. The process results in fat necrosis and scarring. Keno log is a long acting steroid, so I generally recommend waiting for at least 6 months prior to performing any definitive treatment. Initially, conservative therapy, including message and ultrasound therapy, is advised to soften the scarring. I have treated several patients with similar dents. I generally do not recommend the temporary fillers due to the large volume required to correct these deformities. Fat transfer is ideal to correct this problem. Fat transfer can be performed in the office with local anesthesia to fill in the contour deformity. Most of the time only one treatment is required. If there is a large deformity, or excessive scar tissue, a second treatment may be required.

I would recommend consulting with a Board-Certified Plastic Surgeon.

Best regards, Andrew Lyos, MD, FACS

Andrew T. Lyos, MD, FACS
Houston Plastic Surgeon
5.0 out of 5 stars 22 reviews

Fat grafting great option for correcting contour deformities

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Thank you for your question. You have several good options to correct this authority. One option they should consider is fat grafting to this area. Keep in mind that steroid injections can permanently damage the skin and underlying tissue. This will not correct itself with massage or other noninvasive modalities. With fat grafting, we can perform liposuction and take fat from one part of your body cleanse and process it and then transplant the fat to your depression caused by the steroid injection. It is important to keep in mind that not all the fat may remain in place. Approximately 20% of the fat may melt after being transplanted. For this reason, it is important to go to a plastic surgeon with a great deal of experience in this procedure so that as much as possible will survive and that his deformity may be fixed in one stage.

For more information on fat grafting or butt augmentation, please schedule an iConsult or visit us online at the link below.

Pat Pazmino, MD
Miami Plastic Surgeon
4.5 out of 5 stars 65 reviews

Correcting fat atrophy caused by corticosteroid injection

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Hi Dooby,

I've taken care of a few patients who developed significant atrophy of the fatty tissues after corticosteroid injection. The first thing to realize is that atrophy of the fat is a process that evolves over several months. Before you seek any long-lasting treatment, the best thing to do is to wait for several months until you are sure the indentation isn't getting any worse or any better.

My best results have been achieved with autologous fat grafting. Because the goal of surgery is to replace missing fat, and fat is a semi-permanent filling material, it's always made the most sense to me for this particular indication. Some of the fat re-absorbs in the first few weeks to months after surgery, so a secondary touch-up procedure is sometimes required. All in all, though, the results are quite good.

Hope this helps. Best of luck.

Sam Jejurikar, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 30 reviews

An Indented Scar From An Injection Can Be Improved

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The condition is usually from fat necrosis, which is hardening and then shrinkage and scarring of the fat. A dent results from this.

The first and best thing to do is massage the area....this can really help break up the scar tissue and smooth the area out.

My preference would be to use your own fat to fill in the defect and I would probably wait at least 6 months after the injection to do this.

John LoMonaco, MD, FACS
Houston Plastic Surgeon
5.0 out of 5 stars 169 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.