Reversing Fat Transfer Results?

Three days ago, I had Liposuction done on my hips and back area. Then, at the same time, I had a fat transfer (graft) into my cheeks and folds of my nose area (which I really didn't have). After three days, I still look like miss piggy. I look distorted, and I don't even look like myself. I had full natural lips which now look thinner, and the corners now go downward. I have a tiny nose which now goes up in the air, and fullness in the middle of my face. I'm very disturbed by the results. I was told I would look normal in 4-5 days, but I don't see how in two days i'll look like myself. Is it possible to have the fat transfer removed or reversed? Is there a procedure that can melt or dissolve the fat in my face? The plastic surgeon also said he added more because a lot of it will dissolve. Will it really dissolve, and how long will it take? I'm desperate to have my pretty little features back. Help!

Doctor Answers 18

Some good news!

Fat injections when done well is a great technique for volume replacement. The way you had it done, by taking your own fat by liposuction is a common technique that kills the majority of fat cells being introduced. Thus, the fat cells die and the doctor has to overfill the area. In your case the fat should resolve in a short period of time. There is nothing to do at this time except to have patience.
Fat can be removed later on, just as it was introduced - by aspiration with microcannulas. But DO NOT CONSIDER THIS FOR AT LEAST 3-6 MONTHS.


New York Plastic Surgeon
5.0 out of 5 stars 25 reviews

Swelling after facial fat grafts may last months

When fat grafting the face, it can take months for the swelling to go down. After 6 to 12 months, if you still have significant swelling or lumps, I would recommend micro-liposuction of the fat grafted areas. Micro-liposuction involves very small suction tubes (much smaller than the normal liposuction cannulas) with small openings to remove the extra fat.

If you still have concerns after 6 months, I recommend that you have a consultation with a Board Certified Plastic Surgeon who has experience with micro fat grafting and micro fat liposuction.

Daniel Reichner, MD
Newport Beach Plastic Surgeon
4.5 out of 5 stars 9 reviews

Please be patient

Only a few days after surgery, you are maximally swollen and really won't know what the final results of the fat injection will be until 3 months have passed. By that time, you will probably be much happier than you are right now. Best to wait and see! Good luck!

Do not panic! You are only three days from facial fat grafting.

Lawoman:

Do not panic! You are only three days from facial fat grafting. Of all the facial surgical procedures I perform, I see more facial swelling and bruising following fat grafting. This is due to the number of passes of the blunt needle that is required to distribute the grafted fat cells evenly into the facial tissue.

Be patient…keep your head elevated on a couple of pillows and continue to ice. It is most imperative that you continue to stay in contact and be seen by your treating physician. You may wish to inquire about various medication that you can take to help alleviate the bruising and swelling.

In general, I would not consider removing the fat this early post-operatively. Keep in mind that only 35-40% of the fat graft will survive.

Thanks for your question.

Stephen A. Goldstein, MD
Englewood Plastic Surgeon

Too early to judge fat injection results

As most of the other surgeons have stated, three days after fat injection is far too soon to comment on the results. The good news is that most of the fat placed will be gone.

Can fat transfer be reversed? Yes, but it is very difficult in certain area. Any facial filler, be it fat, Radiesse, etc. is difficult to reverse with the exception of Restylane (HA family).

The fat which has been placed was most likely placed in multiple layers throughout the face with very small amounts (microfat graft, FAMI, etc). Trying to remove a small amount of fat that has become integrated with your body is very difficult.

Frequently patients do not complain about the amount of fat but small hard areas which they can palpate. Steroid injections may be a good place to start, but not earlier than one year.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 94 reviews

Fat transfer results

I agree with Dr. Moelleken in that time is an important part of your progress. When you posted this question you were three days out. You were likely at the peak of your swelling at that point. The swelling should begin to resolve and you should begin to see differences at 2-4 weeks.

The final result will likely take about 6 months to achieve. If, at that point, you feel like fat has been over-grafted, you can have micro-lipo suction through the same incisions to remove some fat.

However, right now, time is your friend. Give your body the time it needs to heal and the results to settle.

As always, contact your surgeon if you have concerns about your post-op course.

I hope this helps.

Steve Williams, MD

Postoperative swelling

Three days after any procedure is far too soon to assess any results.

Fat injections do typically reduce greatly over time, often altogether. No doubt your doctor has told you about cold packs and elevation, and waiting it out until the swelling from surgery reduces. If the swelling is abnormal or you have any doubt, obviously check with your doctor to make sure there is no abnormal bleeding in the tissues that causes undue swelling.

Once typically 6 months have gone by, that is usually the time to assess critically to see if any revisions need to be done, rarely before that time point. Specifically with the technique of fat injection, some of the retained voloume may consist of nonviable fatty cysts, so it may be possible for your doctor to "smoosh" some of them with direct pressure, causing rupture of the fatty cysts. Obviously you should not try this yourself.

In my experience, fat injection fat can be tough, like gristle, and can be quite difficult to remove with liposuction or from certain areas such as the lower eyelids (we do not do fat injection techniques in the lower eyelid area). Revisions in the nasolabial area are generally much more straightforward.

Patients may also want to consider nontraumatized fascial fat grafts (LiveFill), which have greater viability when they are placed and therefore do not require overcorrection.

But again, 3 days after surgery the mirrors in your house should generally be taped over and you should be catching up on your reading and DVD collection!

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 114 reviews

Don't dispair, time will help

Time will help your problem. This early after your procedure you likely have some amount of swelling which remains. In addition, a certain amount of the fat will absorb, more in areas of the face which are highly animated such as the lips. Unfortunately this will take time. I would agree with Dr. Freund that I would wait at least 3-6 months (and more towards the 6 months) before even trying to aspirate any fat.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
4.0 out of 5 stars 13 reviews

Must give it more time

Swelling after fat grafting can be significant, depending on where it is placed, how much, and the technique used. At minimum you need to allow 2-3 weeks to get  a reasonable idea of the appearance, and 2-3 months to have a final assessment of the amount of fat that survives the grafting procedure. Try not to panic at the moment. I find that the toughest thing as a surgeon who performs fat grafting routinely, is reassuring fat grafting patients as they go through the first few weeks of swelling. It's just way to early to make an assessment of the final result.

I have actually changed my technique over the years to use smaller amounts of fat at any one time to cut down on the swelling and allow a quicker recovery. With the availability of our own FDA registered lipobank, we can store fat in small amounts to allow repeated procedures to be done without the need for more liposuction.

 

Jeffrey Hartog, MD
Orlando Plastic Surgeon
4.5 out of 5 stars 50 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.