Fat Transfer Q&A

52%

WORTH IT RATING

136 Reviews

Ask a Question

View Before and Afters

Average Fat Transfer Cost: $3,950

Learn about Fat Transfer

1,090 people and 473 doctors are talking about Fat Transfer

Get Free Email Updates

Tear Trough Area Lump After Fat Transfer

asked 3 years ago by 1femmefatale in canada
Latest answer by Larry S. Nichter, MD, MS
Question viewed 13,459 times
Tags: tear trough, lumps, side effects

I had fat transfer done in April 2008, and after two weeks, a visible lump formed on my right cheek and a larger bulge on my left side, but it's visible only when I'm smiling and laughing. Since then I seeked the advice of 5 other doctors, all unwilling to touch my face, all telling me different times (from 6 months to 3 years) to wait it off. What can I do besides waiting for months or years "to see" if it will go away? Can I get a proactive approach to a solution instead? Thank you so much.

14 answers to Tear Trough Area Lump After Fat Transfer

Revisional lower eyelid surgery

There is nothing wrong with waiting until a problem is stable, and at that time reassess critically to see if any revision surgery needs to be done. Usually this timepoint is some time after six months. Fat injection fat can sometimes be aspirated with a very fine liposuction canula. In my experience, however, this is sometimes touch since the fat that does survive tends to be very "gristly" and does not aspirate well through a canula. Sometimes the adjacent native fat is more... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

www.drbrent.com

You may need a revision.

With fat grafting or any procedure, it is possible for you to develop "lumps," especially if you are being injected by an inexperienced injector. However, now that you have a lump it is best to wait some time before jumping into additional operations or procedures. These additional procedures are not without their own risk. It is important to seek the opinion of your surgeon and, possibly, other surgeons as you have. With out examining you myself, it is hard to give you specific advice.... more

David Shafer, MD
New York Plastic Surgeon

www.ShaferPlasticSurgery.com

Very difficult to give you a quick answer

As the other doctors have mentioned, this could be a cyst, scar, hardened fat, etc. Fat transfer in the lower eyelid area can have great results, but can be very difficult to correct. It is wise to wait at least a year to see how this lump "matures." It should be treated based on how superficial and how deep it is. Some superficial ones can be cut out directly. Some deeper ones can also be carefully cut out. However, in some patients who have difficulty with nodules and lumps as a chronic... more

Sirish Maddali, MD
Portland Plastic Surgeon

It is best to takes a stepwise approach

Without examining you or looking at a photo, it is hard to give you sound advice. But, the first step is to find an experienced fat transfer surgeon who performs many treatments around the eyes. As a general conservative approach, the first step is often direct micro-aspiration during the early phases (i.e. within a month). The fat is still soft and can potentially by suctioned out. This can be coupled with massage, but massage alone rarely treats the problem completely unless it is... more

Amir M. Karam, MD
San Diego Facial Plastic Surgeon

www.drkaram.com

Fat Grafting Lumps When Smiling

Hi Femme Fatale, Sorry to hear that you are suffering from fat graft complications. Most importantly you should continue following the advice of qualified and experienced fat transfer surgeons. Accent XL is a non-invasive method of sculpting fat. It may be possible to smooth your "lumps" with a series of treatments. This area is extremely delicate. Your evaluation should be performed by someone with a great deal of experience. Microliposuction may help if there is a... more

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon

Plan to wait one year!

Contour irregularities after lower eyelid and/or cheeck fat injection can be very difficult to correct. There are a number of variable that affect this difficulty, including what level the fat was injected. If the fat was injected very close to the skin surface, this is more difficult. As I am not seeing you as a patient, I am not able to comment on your specific case but I can offer some general thoughts. I have treated patients in the past with fat irregularities after injection and I... more

Julius W. Few, MD
Chicago Plastic Surgeon

Sounds like a cyst or irregular placement of injections

Fat should have the same texture and softness as the underlying fat. This is different than other fillers which are typically harder, and appear harder when you smile. Your description of seeing the lumps only when you smile suggests that the material is harder than the surrounding tissue. This could be swelling or a localized cyst. If it is just swelling then wait, if it is a cyst then surgical removal may be in your future. If you have the lump at all times, perhaps you need more filler. more

Robert M. Freund, MD
New York Plastic Surgeon

Fat lumps in the tear trough -no easyway out

The problem you hane is not unusual and I have seen similarly affected patients who needed surgical revision. For some reason the fat injected in the perioorbital area tend to survive and thrive- may be because of the rich blood supply. I beleive the the fat was injected under the muscle in your case and that is why the lump becomes prominernt when you smile as the muscle contract over it bringing it in relief. This fat is going to be with you for good. Only... more

Zain Kadri, MD
Los Angeles Facial Plastic Surgeon

Lumps and Nodules following Fat Transfer

I agree with the advice of the other physicians you consulted for several reasons - not all fat survives and sometimes the fat necrosis/liquefaction process of fat cells that do not survive will create inflammatory lumps or nodules that overtime will self correct or can be aspirated if liquefied. On the other extreme, you will not know if this is because too much fat was injected until several months.The bottom line is that many factors are at play and waiting is the best medicine.... more

Larry S. Nichter, MD, MS
Orange County Plastic Surgeon

drnichter.com

Fat Lump After Fat Grafting

The lump on the cheek may represent either a part of routine lumpiness or irregularity after fat grafting that will improve on its own. Sometimes, injection of steroid can help. Alternatively, if the symptoms did not improve small excision may be needed to correct the deformity. Prior to deciding to any surgical intervention it is important to give enough time for swelling of the tissues to settle down appropriately. Sincerely, Boris Volshteyn M.D., M.S.

Boris Volshteyn, MD, MS
Reno Plastic Surgeon

Be Careful.

I understand lumps after fat transfer are frustrating! Those of us that perform a significant amount of fat transfer are very careful in the undereye area since lumps can be visible for a prolonged amount of time. Waiting for them to resolve can be unbelievably difficult on patients and surgeons. Sometimes waiting is the best bet so as not to cause additional problems (scarring, depressions, etc). If you want to be proactive, however, I like massage, steroid... more

Randolph Capone, MD
Baltimore Facial Plastic Surgeon

Fat Transfer Lumps Can Be Treated

Having lumps after fat transfer is not unusual. At this point if you are 2 years or more out from the procedure, it is defintely worth attempting treatment. The best treatment is dependent on a number of factors but your options range from intralesional steroid or 5-FU injections to microliposuction to thermal heating to surgical excision.

D.J. Verret, MD
Dallas Facial Plastic Surgeon

There are things you can do to improve fat transfer lump

There are things you can do to improve it. Waiting is one option. But you have to tailor the option to the desire of the patient. One option is to inject steroids, but you have to be aware of the risks of this. The next option is to actually make an incision to take out the fat. Although this will leave a scar, but you can always improve the appearance of the scar. Another option is to do micro liposuction to remove the lump, and this takes experience. Try to find a surgeon willing... more

Philip Young, MD
Bellevue Facial Plastic Surgeon

www.drphilipyoung.com

There may be options

Without examining you, I can not specifically comment on your case. This could be the fat itself or scar tissue. However, direct excision of the lump may be possible. One colleague even reported that if it is smalle enough, he will often "pinch" it with surgical tweezers and it helps break it up.