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Why Do I Have Uneven Cheeks After Fat Transfers and Face Lift? (photo)

I am 7 months post op. I do not have smooth cheeks after fat transfers to areas beside mouth and face lift. What is the cause of this and what can be done?

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cheeks uneven 7 months post-op fat graft

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19 Doctor Answers | Asked by corbarlin

Doctor Answers (19)
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Fat injections/ fat transfer

The unevenness in your face maybe, do to uneven placement of fat on your face. After 7 months, do not expect that the results would change to much, and as to the treatment new fat injections and probably some fat suction is recommened.

Uneven Cheeks after fat transfer

I ask my patients to wait 6 months before making a final determination, as autologous fat grafting does not survive 100%, and I generally slightly over-correct because of this. I feel that it takes approximately 6 months for everything to even-out and if, indeed, there are asymmetries, I can address them at that time.

Jonathan Berman, MD

Palm Beach Plastic Surgeon

www.drberman.com

Uneven cheeks after fat transfer

One of the downsides of fat transfer is that the fat may not be absorbed equally on both sides. We still know much too little about the mechanism of fat transfer. In this case, you may need a touchup on one side. Depending on your feelings about fat transfer at this point, you could either have additional transfers or try conventional fillers, such as Radiesse, to improve hte contouring.

Uneven Cheek following facelift.

Thanks very much for your question. It's difficult for me say for certain without seeing pre-operative photos. However, it is common for only portions of the fat transfer to remain after the procedure. If you have some unevenness speak with your doctor. Some may go away on it's own but some may require a minor touch up procedure and only they would be able to give you accurate information since they know what was done during your procedure.

Irregularities after Facelift and Fat Transfer

It is difficult to make any suggestions from this one photo. If you posted photos of both sides of your face as well as preoperative photos more helpful suggestions could be made. Fat grafting to depressed areas is reasonable. Find a plastic surgeon with ELITE credentials who does hundreds of facelifts and fat transfers each year. Kenneth Hughes, MD Los Angeles, CA

Face lift fat grafts

Thank you for your question about your fat grafts after your face lift. Your post face lift photo suggests possible facial scarring, more fat survival than planned or irregular fat injection. As your surgeon about your treatment options. Very dilute steroid injections, re-draping skin, removing scar and/or fat or careful new fat transfers all might help. Discuss this with your plastic surgeon and together make a plan to correct it. Hope this helps! more

Uneven after fat grafting

Fat grafting is not an exact science and the final results depend on many variables, including the quality of the fat harvested, the technique used to process and transfer it, as well as the area it is being placed. Over time the results have improved but not perfected. The areas which are uneven I believe can be treated with either further grafting or off the shelf fillers. Discuss your concerns with your surgeon who I bet will want to help you, and probably give you the best deal. Good luck. more

Irregular contours after facelift and fat grafts

Can occur. As you are several months post-op, you are at a point where revisions can be considered. You should talk to your surgeon about revisions and what kinds of costs you are looking at. Fat grafting, as good as it is, is not a guarantee that the tissue will take. Another great example of why everyone should know what their doctor's revision policy is...

Curtis Wong, MD

7 reviews

Redding Plastic Surgeon

Cause of Uneven Cheeks after Fat Augmentation and Facelift

If you did not have this asymmetry before surgery it is secondary to scarring after the facelift or uneven placement or survival of the fat. A minor revision of the facelift can be done. I have been doing fat transfers for over 25 years because I prefer using the patient's own tissue whenever possible. Problems with fat or fillers are frequently technique dependent. If the fat is causing irregularities more can be injected to improve the contour.

Richard W. Fleming, MD

9 reviews

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Facelift and Fat Transfer

As others have stated, the asymmetries are most likely related to the survival and lack thereof the fat grafts Although the technique has strong proponents, my preference is to use Sculptra in shaping facial volume in conjunction with a facelift. Sculptra offers gradual facial volume changes that is safe and predictable without need for a donor site. Both fat transfer and Sculptra require repeat procedures in order to accomplish the desired result.

Contour irregularities in face after fat grafting--what to do.

At 7 months, what fat is living will remain alive, but the fat that does not survive initially can still be palpable and visible as firm or irregular areas (scar fibrosis). As others have stated, fat grafts to the face can be unpredictable and not 100% of the transferred fat survives; thus, irregularities can indeed occur. Technique is critical for best "take" and results, but even with the best possible procedural details this kind of outcome can be seen in some cases. At this point,... more

Asymmetry after Facial Fat Grafting

Thank you for this great question. Fat grafting can be a great treatment, particularly when it is paired with other techniques like a facelift. The reality is, however, that not all grafts will "take" (survive), and this can lead to some asymmetry in the result. An additional session of fat grafting, after an appropriate amount of time allowed for healing from your operation, will generally help. Having a open conversation with your surgeon is essential during this process. Best of luck! more

Depressed cheeks after face lift- why?

Without benefit of exam, it appears to me as if some of your fat graft has failed to take. If I could palpate the area, or see it animated, I could tell for sure. Either way, I think that an additional round of fat grafting or two will correct the situation. sek

Unevenness after fat grafting

Fat grafting is a wonderful filler option that has a tremendous upside with respect to producing a natural, rejuvenated look. Unfortunately, it can be unpredictable. I would check your before pictures to determine how much asymmetry was present before surgery. The best option would be to re-graft the area in order to provide a smoother contour and create more symmetry.

Todd C. Miller, MD

10 reviews

Orange County Facial Plastic Surgeon

www.toddmillermd.com

Why Do I Have Uneven Cheeks After Fat Transfers and Face Lift?

I don't use fat transfer for facial shaping because of the uncertainty of the final results. When shaping the cheeks, a difference of a mm or so can be noticable and IMHO this makes fat transfer unreliable. I prefer using a reliable, stable temporary filler (I prefer Perlane) or Cheek Implants for a permanent augmentation. Further, IMO it's absolutely essential that the plastic and cosmetic surgeon understand and follow the proper aesthetics of the face and cheek to... more

Asymmetry after facelift and fat grafting

Occasionally after fat grafting, there could be some fat resorption, causing asymmetry. There is some hollowness under your cheekbone but your skin is tight. A small amount of additional fat grafting should take a problem for you.

Asymmetry after face lift and fat grafting

Mild asymmetry after a face lift and fat grafting is not unusual. The most common cause is preexisting facial asymmetry that is now more apparent after the surgical swelling has subsided. Review your before and after photos with your surgeon and discuss your concerns. If the asymmetry is related to inadequate fat volume transfer, your surgeon should be willing to add more fat to the side in need. Good luck!

Fat transfers can yield asymmetrical results.

Fat grafting has a degree of unpredictability. Asymmetries after grafting are not uncommon. Generally this is dealt with by re-grafting areas that are relatively deficient.

Why Do I Have Uneven Cheeks After Fat Transfers and Face Lift?

Very poor one posted photo, better to post full frontal,oblique face views. Causes are poor technique of injecting, clumping of fat grafts, irregular swelling issues. Best to seek ONLY in person advise. A thought is intensive massage, external ultrasound therapy, injections of Kenalog to areas, re fat grafting.