“Fat Transfer - Gambling with Your Face - California”

I really liked my face.In hindsight,the minimal "refreshing" I wanted was something that at my age should have been done with fillers.

Myth 1) It's non-invasive.I was shocked at my appearance after the procedure and was swollen for months.It invaded my life.

Myth 2) It improves skin texture.For all this stem cell talk,I didn't get it. In addition to the broken capillaries,minor injection site marks and rippling at the doner site,my skin looked stretched and had an orange peel appearance when the swelling finally went down. The $4,000 I'd spent on Total FX 6 months earlier to perfect my skin was a total waste after this procedure. I'm now going through another less invasive round of skin resurfacing.

Myth 3) An unpredictable permanent fat solution is better and more cost-effective than other more predictable fillers.If you're willing to risk the probability of permanent lumps and irregularities then go for it.If you can afford to pay to fix the possibility of problems,then take the risk. If you're prepared to use even more fillers to correct the asymmetry and areas that weren't filled so everything matches, go for it. If you are prepared to never look the same, sign up. If you are convinced you won't gain weight and inflate the unwanted transferred fat - then do it. I wasn't prepared for those things and I am one very sad person who didn't know what I had until it was gone.

Tip 1) Don't go for the most charismatic doctor. Go for the critical perfectionist who seriously discusses the cons and takes the time to analyze your face and it's current imperfections.

Tip 2) Have him/her draw a picture of exactly where the injections will be so you aren't surprised where they end up.

Tip 3) Establish expectations. Ask how long you will be swollen and what constitutes swelling vs. final results. Ask what the plan is if you aren't satisfied with the results.

Tip 4) Look at his/her staff. Do you like what you see? They've often had something done and you may be able to gauge how conservative or extreme the doctor may be.

Tip 5) Don't just fall for "stock" photos or carefully selected picture books.

Please note: I'm just sharing my experience and opinion. Some people may benefit from this procedure.

Updated on 30 Apr 2011:
I've described my process for F/T removal toward the bottom of this review. The process has included 5FU injections, fillers, and Micro-lip. I'm not done yet, but you can get an idea of what this all entails. What you'll find is that fat is easy to stick in, and not so easy to get it out!!

Updated on 22 May 2011:
Here's where the story ends: 3 weeks post micro lipo and things are going well. As a critical perfectionist, I'll always see the flaws but I'm blessed to have found a skilled Dr. who was able to undo much of the damage. There are some things I have to accept. You can never go back and I'm a year older, the stress has taken it's toll and my once big smile is now tainted with utter fatigue. . ..but it's time to move on. I can at least have a photo taken without looking like someone shoved little sausage links up the side of my nose. I've never publicly announced the Dr. who did this to me. . .the one who took a year off my life and bank account so that he could make a car payment.However,I will confirm that it is Dr. Jonathan Hoenig in LA who has been meticulous in his approach to correcting this. We'll continue with fillers to tweak things and slowly I'm re-entering life. I went out to dinner in my town for the first time in almost a year and held my head up. It was hard, but baby steps. For everyone who comes to this site for hope. . It's there. . .but it doesn't come without patience, research and a price! Good luck everyone.

Updated on 7 Jun 2011:
The Trade-off: I'm about 5 weeks out from my Micro and I continue to deflate. My doctor did a good job and my contours are coming back, but you all need to know the trade-off. Yes,some things are fixable. However, I've put my face through hell this year. I now have hollows I never had and probably wouldn't have had based on genetics. I also have a lot of slack skin and poor texture. Ironically, I'll need to be filled to fix that. This expectation was completely set going into my micro. You can't inflate and deflate and torture your face for a year without ramification. I look worse than when I started, but better than I did with the improperly placed fat. I go back for assessment in about 3 weeks. Again, if you decide to do this or are thinking of fixing an FT. . .I'm just providing my experience based on my personal choices.

Updated on 5 Jul 2011:
The final step is where I should have started: Almost a year to the date that I basically lost my mind and made the fateful decision to go through with this procedure, I'm looking much, much better. It has been a journey I wouldn't wish on anyone and I've lost a lot along the way. Apparently I was suppose to learn a very important lesson about what happens when you think you have to be perfect. Things can go REALLY, REALLY wrong. All I ever needed was some Restylane. Thousands and thousands of dollars later, I will still always need Restylane:). Remember that when someone promises a permanent solution. . .it may end up being a permanent problem. Are you prepared for that? I feel really lucky to have been fixed to the extent that I've been fixed, but I'll never be perfect. And you no what? After all this, if I'm smart, I'll quit before I gamble my new found winnings away! Please learn from my mistake and be prepared to own your decision - no matter what it is and what the outcome. After all. . .it's your face.

Updated on 20 Jan 2012:
Hi everyone,
It seems that everyday someone pops up on this site who is experiencing the first horrible OMG moment following this procedure. Those of us who have been through it know it well and it’s heart-breaking. As the months continue, you will go through all the stages of mourning, including the feeling that all hope is lost. . . The depression, the anger, the denial, the bargaining, and if you’re lucky, you may come to some sort of acceptance.

For any of you following my story, I am a year and a half out from my initial bad Fat Transfer surgery and have gone through a fat removal process that involved the right doctor, 5FU injections, micro-lipo and time. For the most part, this has been successful. I will say that even after the micro, it took about 7 months more for me be able to say that most of the fat is gone.

Every situation is different. Please know that when you decide to go through a Fat Transfer, successful removal is extremely difficult. A perfect return to your original state is almost impossible. If you haven’t gone through this procedure and your Dr. tells you that you need a “refresher” – stick with fillers! FT is not a “refresher” procedure. It is major surgery and recovery – a lot of swelling. If you like the way you look and just want a little something. This is not a “little something.” Stick with fillers. Fat has a place, but not for minor to even “more than minor” tweaking. It has a lot of risk.

Here’s where I’m at now. . . I’m going in for a conservative brow and upper eyelift. When the fat was removed a few things happened: 1) All the initial “minor” issues are back and they are now bigger issues than when I started - with a few more imperfections and irregularities. 2) My skin has sagged some in the temples and eyes where I did have fat injected. The stress, weight loss, age, and some laser damage (in an attempt to address the FT issues) have all contributed to the sag. I have volume loss, but will stick to fillers after the lift. Doing another ‘round of fat would be like me asking you to hit me over the head with a sledge hammer – AGAIN.

Please read below if you want to know more and are trying to decide if this is something you want to consider. Please think twice. This has been an expensive and painful road to travel. I’m probably one of the lucky ones but it will still take a lot of work for my life to ever resemble what it was. So if you do this, do it with eyes wide open.

I’ve most recently been posting on the thread, “Has anyone ever successfully corrected under eye fat transfer?” If you want to learn more, those posters are also well-versed in the cost of personal and financial well-being following this procedure. They also offer some good information.

Plastic Surgery is a slippery slope with no guarantees. If you weren't crazy going in, you may get a little crazy when you come out if things don't go right. .. but you're not alone.

Updated on 24 Mar 2012:
Can you ever be fixed from a botched Fat Transfer? One of the things that we all notice on these sites is that it's rare, if not heard of for people to document getting "fixed".

Here are a few of my thoughts:
1) Many people don't find a solution (it's very, very hard)
2) People never come back to report on what they did to get fixed
3) Once you do something like this, your brain has a very hard time reconciling the difference in the mirror and it can take years to get over the "identity crisis" even if you've been somewhat fixed.
4) Even if you are fixed and look good by most standards, you will most likely still never look like your before pictures so it's difficult to feel fixed.

I probably fall into category 4 (I'll explain in the last 2 paragraphs). I just went through a brow/temple lift to hike up what sagged after all the nightmare of injecting and removing and sucking, etc. Dr. Hoenig is a master in this area and it looks great.

Here's are the catches: I still have some of the injected fat in areas that are too risky to try to remove further, and my asymmetrical cheeks look even more asymmetrical now so there are things that are "off" when you compare before and after pictures. My skin has been through hell and looks tired and lifeless and the original cannula marks are there. I used to be known for my pretty skin - even by the office that did the botched job. I never hear that anymore. And all the expensive crap I've tried has just made things worse.

I've been filler free for a while now, so in a month, we will begin the process of playing with fillers to minimize the asymmetry and continue to improve the baseline we now have. Medium TCAs, Tretinoin and Hydroquinone are being used to improve the skin.

Last week I showed my BEFORE FT pictures to a friend - alongside the pictures of me taken 20 months POST my botched Fat Transfer. Again, I've had 5FU, Micro-lipo, and a brow/temple lift throughout the fixing process. I asked her if she would say I was fixed - because I don't know what to tell you all.

She said, "Well, these are both attractive pictures. You were more attractive before, but no one who hasn't seen the before pictures would know what happened. She said I could be described as a twin. There's is a familiarity, but we're not identical." In other words, I have to accept my new reality. I've been relatively successful. If you can accept the fact that you will most likely never look the same after a botched FT, but that you can get a lot of improvement - then you'll be ok. If you hold out chasing the dream of seeing the exact same face again - it's really dependent on how bad the FT was and probably rare if not, almost impossible - even when you work with a great surgeon. There's only so much they can do.

Updated on 25 Mar 2012:
Well, I continue to test my new "fixed" face and thought this might hit home with a few of you. Like many of you who have been botched - I went into seclusion. I quit dating. I only went out to do errands at night when stores would be empty, or with sunglasses on. I cut out friends, family and anyone who might comment on my altered appearance. I couldn't stand the quizzical look I'd get, or the sympathy look, or even the interactions I didn't enjoy anymore. It was just painful and I felt like I was slowing dying for almost two yrs.

So, I'm 18 days out from my brow/temple lift and I looked in the mirror this morning and said, "Ok, you look as good as it's going to get and it's not horrible." I put on a cute outfit and went to the Starbucks to get some work done. What sounds like a normal thing for most - was a momumental undertaking for the queen of Jackie O glasses.

HOWEVER, my relief quickly turned to the reality. I stopped at the grocery store. Once again, I removed my sunglasses which had been my lifeline for almost 2 years. BAMM!! Within 2 minutes, I ran into someone who hadn't seen me since 6 weeks PRIOR to the Botched Fat Transfer. He didn't know I'd done it and I'd just disappeared from life. He'd known me for years and we'd even dated. He was the guy that always greated me with "Hello Beautiful". Not this time. He did a double take and said, "I didn't recognize you. Is it your hair? Your face looks longer? I'm mean, you look good, but different." I wanted to get out of there as fast as I could and throw-up.

So, there you have it . . . you have to be really strong after this type of disaster. People don't mean to be cruel - they don't know. But, every time you have to face people from your past, you have to face your new reality and be really tough. It is what it is.

Updated on 25 Mar 2012:
BTW: The reason my face looks longer is because the original fat transfer was loaded on my inner upper cheek. It also makes my nose look a little broader. Now that I understand this process and have looked at more photos, I see that it is a mistake that quite a few doctors make. They think they are creating cheekbones this way (even if you don't ask for them.) A checkbone should look like a Nike Swoosh and not start so high up and under the eye. It's very unnatural looking.

Updated on 8 May 2012:
So, the last part of my 15-month repair journey was to have everything filled back up again with Restylane and it looks really good - temples, lateral brow, cheeks, under eye. That, with the brow/temple lift, has made a huge difference.

I hadn't had any fillers in about 10 months and about 17 months in cheeks, temples, etc. I have such a thin face that it was getting distressing to see all the hollows. In theory - the fat was a good idea. In practice - it was a nightmare. Bad original surgeon, bad technique, horrible outcome and two years of my life down the tubes. All I ever needed was a one syringe of filler for my face in the first place - MAX. For what it's cost me to fix this mess - I could have had fillers in my face a couple times a year for the next 10 years (NO EXAGGERATION).

That said, what's done is done. What a difference the right injector can make. The right Doctor knows exactly where to put everything so you look symmetrical and NORMAL. He or she takes the time to make the filler go as far as it can. A little here, a little there. . NOT a big blop in one cheek and then open another syringe!

Next, I have to fix my skin that was damaged between the swelling from the FT and the laser work. I'm interviewing Doctors now and taking this very slowly. There is no room for error here. I've learned the hard way that patience is the name of this game.

READ ME: Which brings me to my last point. . . IF YOU HAVE BEEN DAMAGED by any cosmetic procedure. Please, please take a deep breath. This is not a sprint, it takes a lot of time and patience to fix this. I know you are in dispair and I know you want to get this fixed because you think you want to die. . .but do NOT rush into having ANYTHING done. It will only MAKE THINGS WORSE and harder to correct.

You are in the information gathering stage at this point. Do not let every doctor you go to do something else. If the original doctor says he'll fix it - wait 'til you get a second opinion. You are not in a great decision-making place and you need to find the BEST solution. You get one real shot at the revision - make sure you find the absolute best Doctor out there. You can only find him or her by doing a lot of research and going to several consultations. I know it's costly. It sucks. I've been there - but please learn from all my mistakes.

Updated on 11 May 2012:
Laser/IPL Damage The Possible Cause of Poor Fat Take!
WOW, I just has my skin analyzed by a doctor who had one of those machines that can digitally show skin damage. I told him that I was pretty sure I'd been damaged by an overly agressive tech using an ALMA photofacial machine about 6 weeks prior to my original FT. (Keep in mind - the place I went to for the photofacial was recommended by the original Plastic Surgeon's office!) The derm asked why I thought I had been damaged and I explained. We looked at the image and he showed me where the damage (square-like scars) was and explained that the area had clearly experienced devascularization. My mind was racing.

Devascularization is loss of the blood supply to a bodily part due to destruction or obstruction of blood vessels!!! In other words, it is highly probably that this area would struggle to "take" the fat - and in fact, it didn't take on that portion of my face. Studies have been weak in regards to the corrolation between laser/laser-like devices and fat transfer - before or after. Again, buyer beware. Though photofacial is not a laser - damage is damage and I don't think most people know what these machines do.

Now - this is by no means the only issue I had with the fat. It was lumpy and placed incorrectly - and you know the story; however, this is certainly another piece of the puzzle. I'd told the patient coordinator at the office about my experience prior to the procedure. 1) I should have been educated about not having ANYTHING done prior to procedure 2) There was no concern about the fact that I thought I'd been burned. In fact, she told me, she had only heard of there being problems with people having "laser" work done after a Fat Transfer and 3) I'm thinking that people undergoing this kind of stuff should not have any laser work done before or after for quite a long period of time, and be evaluated if they have.

I'm pretty sure my doctor had no idea what he was doing - so him and his staff wouldn't know any different. However, this should seem fairly obvious to someone who is suppose to understand how a Fat Transfer works. What do I know.

My curiosity is - if these image machines are available and can show areas of poor supply - which is an important part of a successful transfer - why don't doctors who are performing these procedures have the machines - or do better job of educating people of these risks? UNBELIEVABLE!!!!! Perhaps this is just another hypothesis on my part. . . but it's as good as any I've heard so far.