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Can I Reverse Fat Grafting to my Cheeks After 6 Years? What about ATX-101?

I had fat grafting to my cheeks 6 years ago, and the results were permanent. Not much disappeared. I had more fat grafted around my cheeks to change the proportions, but that just made my face looked fatter. I then had some fat removed with microlipo, but not enough. The fat is so much a part of my facial structure now. I've got the bigsculpted cheeks whereas before my face was small and angular. Very different from how I used to look, and I never got used to it. What about ATX-101?

Doctor Answers 9

How to reverse fat grafting


Over the last decade fat grafting has become a much more popular procedure. In the right hands it can be an excellent way to add volume to the face or other parts of the body. Unfortunately the survival of the fat is variable and in your case it sounds like too much survived (rarely the problem). Micro lipo with a very small cannula is probably the most precise method for fat removal. Any injectable agent is going to have a variable result and ATX-101 is not yet FDA approved. I recommend that you try the lipo procedure again. 


Daniel Medalie MD

Kybella for cheek fat reduction

There are some ways to reduce fat in your cheek and sculpt the face to make it appear smaller.  Kybella is only approved for reducing fat under your chin.  There are no studies that have evaluted the safety and effects of Kybella for cheek fat removal, therefore, I do not recommend using Kybella in this manner.

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 95 reviews

Liposuction vs Kybella

Thank you for your question.  I would recommend that you visit with a plastic surgeon who can discuss you whether liposuction of the cheeks would be an option versus filling around the cheeks to allow for a more balanced volume distribution in the face.  I would not recommend Kybella at this time given the vital structures in the cheek that can be affected.

Kybella is not a good idea for cheeks

I am sorry to hear that you are unhappy with your fat grafting results. Unfortunately, Kybella would not be a good idea in the cheeks for two reasons: first, it may damage your facial nerve, which would affect the movements of your face and second, it may remove too much fat from your cheeks giving you the opposite problem from what you are dealing with now. Microliposuction is the most precise way to address this issue. Best of luck!

Meghan Nadeau, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 3 reviews

ATX-101 and Fat Grafting

Dear pinkwoo,

ATX-101 or Kybella addresses the submental fullness, which is sometimes referred to as "double chin," in one 15- to 20-minute in-office treatment session. Kybella is the first and only FDA-approved nonsurgical treatment that contours and improves the appearance of your face by destroying the fat cells that sit beneath your chin. I suggest consulting with a board certified facial plastic surgeon to receive the highest quality knowledge, care, treatment and results.

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.5 out of 5 stars 54 reviews

Kyballa Post Fat Transfer

This maybe a potential use for this medication in the future.  For now it is FDA approved for the submental area and the safety hasnt been evaluated for use in other areas.  I use 5fu/steroid injections to reverse any fat transfer irregularities or issues.  Fractional or deep RF help to smoothen out tissue as well.  I suggest seeing a cosmetic dermatologist with experience in body shaping and fat transfer. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
5.0 out of 5 stars 113 reviews

Uses for Kybella

I am at the American Society of Aesthetic Plastic Surgeons meeting in Montreal right now and just had a long discussion with the Kybella people. They will reveal the costs in 2 months but it will be comparable to the cost of chin liposuction. They do not have FDA approval or studies for use anywhere else on the face. It will be widely available in July or August. Can't wait!

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 34 reviews

ATX 101 for the double chin - newly approved by the FDA

ATX 101 is a very exciting product that has been FDA cleared for the double chin. As of this writing, it is not yet available for clinical use. 

In its initial application, ATX 101 is only going to be used for the double chin and not for any other areas. 

We don’t have all the answers with ATX-101

Thanks for the question, and as of now we don’t have all the answers with ATX-101. It appears you have had some issues with your fat grafting – I am sorry for this. We always recommend you have these procedures performed by board-certified dermatologists or plastic surgeons who are the most skilled in these procedures.

ATX has the potential to be a real blockbuster in our aesthetic field – we need to understand that the approval for it will be the double chin area, and anything else that we treat with it will be considered off-label use of ATX. While physicians can use any drug in an off-label fashion (that makes sense), we have no data on how this might work in your particular problem.

Michael Gold, MD
Nashville Dermatologic Surgeon
4.0 out of 5 stars 15 reviews

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