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Lumps from Blepharoplasty, Neck Lipo, and Fat Transfer?

I had liposuction on my neck, lower blepharoplasty, and fat transfer to my face and under my eyes 9 days ago. I just wanted the fat under my eyes to correct hollowness, but the doctor thought I'd look great with it transferred to cheeks, lips, etc..

I'm looking great, but during my massage, I noticed a small painful cyst right between the outer edge of my eye and temple. So then, I explored further and deeper with my hands; there are also two larger lumps (peanut sized), in the exact same spot on either side of my jawline. They don't feel cystic, they feel lumpy and flat-shaped. Also, right under my chin, I have 2 two pea-sized lumps directly across each other.

I also discovered a large inflammed-feeling asymmetrical lump on the right side of my Adam's apple that stretches all the way up under my jawline. Of most concern to me is the small cyst near my eye, and the large sore lump on my neck.

I'm hoping the lumps on both sides of my jaw and the two on the underside of my chin are just fat that will soften. Right now, the cyst by my eye is small. Is this from the liposuction or fat transfer? What if it fills up and becomes large?

I love the way my face looks and hope I wont have to have excisions. I don't want scars! I wonder if he will aspirate the cyst, but couldn't it fill up again? I've seen others with similar problems on the message board, and doctors suggesting to wait it out. But I don't want to "wait it out" for these things to become bigger. Is this normal? Any suggestions or advice before I go see the doctor tomorrow? Thanks.

Doctor Answers (13)

Facial fat transfer

+4

Thanks for your question.

It sounds like what you've described could be a few things including small hematomas (collections of blood) or collections of necrosing fat.

It is unlikely that these are new cysts that have sprung up in the last nine days.

You state:

"I've seen others with similar problems on the message board, and doctors suggesting to wait it out. But I don't want to "wait it out" for these things to become bigger."

This is a common feeling - you just want things to move along and that's a completely normal thing to want. But in these cases sometimes intervening (aspirating things that should go away on their own) can cause other problems.

Discuss your concerns with your surgeon. I hope this helps.


San Francisco Plastic Surgeon
4.5 out of 5 stars 23 reviews

Lumpness shortly after surgery

+2

You should address these concerns with your board certified plastic surgeon. These types of problems are common shortly after surgery but may need attention, in case aspiration / steroid injection/ etc. are warranted.

Although it seems that lumpiness after surgery is firm and won't go away, in the vast majority of patients, it does. Patients who "wait it out" and have a successful resolution are glad they did not rush back to the operating room.

In general, swelling occurs shortly after surgery because leaky capillaries are shuttling white blood cells to the area to heal the wound, and water leaks out in the process, making the tissues firm.

The healing process is never symmetrical. Wound healing is quite complex and mysterious, even now. I was never more confused about wound healing than right after I wrote a book chapter on the subject in a surgical textbook.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 92 reviews

Lumps in face

+1

Hard to say what the lumps in your face represent since I did not perform you surgery.  You should review this with your doctor.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

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Lumps may settle down in the healing process

+1

The lumps that are being felt in the jawline are probably related to fat that was injected in that area and/or seromas. Seromas are congealed accumulations of serous fluid that tend to be hard and fibrotic but eventually settle down in the healing process. They usually take approximately two months to subside. The cyst closest to the eye will need to be addressed and surgically removed. The cyst itself has a capsule on the inside of it which has to be completely excised, otherwise it will reoccur.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

Too early to tell what lumps are

+1

As with all surgical procedures, your body takes time to heal. Even though we are living in a "gotta have it yesterday" mentality, our bodies still take time to undergo a certain healing process that can't be rushed.

I am not a big advocate of fat reinjection, because I haven't gotten consistent results. However, there are some physicians to claim to get excellent results.

The lumps could be from areas of fat deposition, they could represent lymph glands responding to the inflammation in your neck, or they could represent fibrin deposition in early scar tissue formation.

Meet with your surgeon about your concerns and ask if massage therapy will help improve the result.

 

Joseph M. Perlman, MD
Houston Plastic Surgeon
5.0 out of 5 stars 8 reviews

Let yourself heal

+1

Lots of temporary contour issues after surgery so be patient until you heal. Fat grafts can initially be lumpy until the inflammatory process subsides. Frequently, after the swelling subsides the lumps may still be felt, but do not cause a lump that is visible on the face.

Richard Gentile, MD
Youngstown Facial Plastic Surgeon
4.5 out of 5 stars 19 reviews

Wait it out

+1

NN,
Don't worry. Your surgeon will not let you "wait it out" if the lumps are getting larger. And, unless they are truly cysts, which is NOT at all likely, they will not grow. Listen to your surgeon tomorrow.

Kenneth R. Francis, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 31 reviews

You are only 9 days after the procedure - no need to worry

+1

You are only 9 days after your procedure - there is no need to worry. My advice is to leave it alone. After any procedure and especially any injections, you are bound to get localized areas of swelling. It takes several weeks for these to dissolve. You just need to be patient and, in all likelihood, you will be very happy. If you post some pictures, we may be able to give you more specific advice.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 56 reviews

Irregularities after liposuction, fat transfer, and blepharoplasty

+1

You have been provided with excellent advice. It really is too early to make any final predictions. I generally advise my patients to allow about 3 weeks to assess the "take" of fat grafts. With liposuction, the disrupted fat is not always completely evacuated by the suctions, and sometimes devascularized fat may remain behind. I would remain in close contact with your surgeon.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

These are commom problems

+1

I havent' yet met a patient who is willing to wait it out. So that's a normal feeling. As you know swelling is normal. However, with fat transfer the selling will be greater. In addition the fat can get infected and more impportantly can necrose. When fat dies it get hard. Nine days is really too short for fat necrosis but not for contour irregularity from the injection.

So for the luminess give it time. For the lesion on temple see your surgeon for wound care. You may need addtional antibiotics.

Steroids will help if you get unresolved lumpiness but this is way too soon for that.

Christopher L. Hess, MD
Fairfax Plastic Surgeon
5.0 out of 5 stars 16 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.