Lumps 16 Days After Fat Transfer to Under Eyelid. Will This Go Away Without Excision?

Swelling can occur asymmetrically. It doesn't mean that it will end up this way.  Your nasal surgery compounds the swelling of the lower eyelids so you have two reasons for the eyelid to be lumpy for now.  You'll have to be patient and follow-up with your surgeon. Give it time and if a revision is to be done, your surgeon will have to advise you when the area is mature and ready for more treatment.

Web reference: http://www.thenyac.com/fillers/index.html

16 days after surgery is too soon to evaluate the final outcome of any procedure.  Though lumps under the eyes after fat grafting is a common complication, it usually is self limited, meaning it resolves on its own in time (or with some cortisone injections).  The nostril asymmetry is hard to evaluate at this time as well.  If there is long-term asymmetry you may need a minor revision.  Allow yourself 6 month to a year to heal from the rhinoplasty before passing final judgment and at least 3 months for the lower lids.

Dear Chocolate,

Not to worry, it is still very early in your healing process after a fat transfer.  It is not uncommon to have 2-4 weeks of swelling after a fat transfer.  The area under the eyes is especially stubborn because the skin is so thin and there is a piece of fascia (kind of like a tendon) called the malar septum, which attaches to the mid cheek area.  If you look at someone who has a black eye, you can see a diagonal line from the inner corner of the eye pointed diagonally downward where the bruising stops.  This piece of fascia (or fibrous attachment) slows the healing process and causes prolonged swelling. 

The fat transfer will also take time to heal as some of the fat will survive, and some will not...that is why we overinject at first.  If you still have a lump in the next 3-4 months, a small steroid injection can help.  It is rare to have to go back to the operating room to remove a lump of fat.

So just be patient, it should resolve with time.

Best,

Nima Shemirani