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“Bad fat overfill - ongoing review”
Spent: $12,000 in LA
I didn't use to think that fat transfers were a big deal. I'm in my 20s and spent money regularly on expensive juve and resty treatments - thought fat would be more economical in the long run and a worthwhile investment.
Sadly, my surgeon didn't listen, lacked ethics and neglected to exercise good judgement.
After pointing out tiny areas to be done (just as I used to do when getting fillers), I was put under and woke up swollen everywhere. In denial, I thought that the adjacent areas had swelled up around the injections. It turned out that my surgeon changed tack and filled my face without consent.
Result?:
Sunken lips, narrowed smile, pillowing of grafted fat in cheek, yellow discolouration of skin/broken veins, hardened fat panels moving up underneath another big layer of fat in my cheeks, face that doesn't belong to me.
I am now searching high and low for a surgeon to remove some of the fat.
Some important facts I've learned about FTs:
- There are many FT techniques that different surgeons use. Read up online and take time to learn about them - depth, passes, levels, amounts, units (cc/ml)
- Injection of fat is done through mutiple jabs - a more invasive process than fillers
- If you have thin/fair skin, irregularities can be more visible
- Injecting fat into the upper lip gives less tooth show; injecting into the nasolabial folds can turn down the mouth
- Faces deplete with bone loss and skin laxity, in addition to fat loss, so fat zealotry can't solve everything. A simple truth that some PSs haven't quite grasped.
- The resorption of fat in the face can make areas appear larger, as surrounding areas get more hollowed out
- Fat cells behave in the same way as their donor site. Choose yours carefully
- Consider whether you'd enjoy the sensation of filler being injected throughout most of your face, before being swayed by pseudo-scientific data or 'facelifts with fat'
Would I recommend FT? Yes. But as a procedure that is used very sparingly like fillers or sculptura or as an adjunct to other procedures. My experience was based on misunderstanding and ignorance and I've been overfilled this past year.
REMOVING FAT:
The new hobby. Anyone trying to do the same or who's gotten success?
Updated on 17 Jan 2012:
Well, here I am 1.5 years later and nothing much has changed except the fat appears to have gotten even more lumpy and irregular. Either that or I'm more sensitive to it. When I come to think about it my problem is pretty severe. I look like a puppet an my skin is all ripply from the constant fluctuations of fat. Most of the problem was that it wasn't injected properly at all in my opinion. I sure wish he hadn't injected it into my skin. Too much volume is a bad thing, but fixing poor technique is very difficult, because fat is more likely to form granulomas, lumps, cysts, scar tissue from poor technique. If the doctor doesn't inject the fat deep into the cheeks, it will just sag off the face. This fat also feels very uncomfortable in areas of motion - it is completely unlike the natural fat in my face.
Some members on RS here have only tried 5-fu injections with some success, others have had micro liposuction, others are considering expensive eyelid surgeries to remove their fat. Some have even had to go through a year of fillers and undergo more fat transfer to correct deformities left by the original. There is also the possibility of having to undergo a facelift to get back the facial contours and restore sagging skin if your problem is very severe. To be honest, I think you need to have a lot of money and time on your hands to fix this procedure, and many of us are exhausted.
I had a lip reduction but it just made things worse. More scar tissue! So that will need to be redone.
What I would say is that if you're young, like I am/was, your options to get rid of this are very limited and you could be stuck with a lifelong problem, so please - anyone in their 20s (or even 30s) - be very careful who you choose for fat transfer and err on the conservative side. Try not to be put under anaesthesia for this procedure and remain awake as an active participant in your treatment.
This review is the subjective opinion of a RealSelf member and not of RealSelf, Inc.
Helpful review?
My Doctor: Name not provided
My rating:
I wish I'd placed a higher premium on ethics and character when choosing my surgeon. I did what I thought was the right thing, going to an LA surgoen with a great reputation. The best of hands is an ambiguous term. Fat is great when used CONSERVATIVELY, but too much of a good thing becomes a nightmare and deeply regrettable. Make sure your surgeon listens, draws up plans beforehand and makes plenty of time for you and your concerns. Do NOT take this procedure lightly.



I am on the same boat as you. My cheeks are very uneven, and is very noticeable, especially when I smile. Now I don't even want to go outside. I really wish that I didn't do this procedure. It has been almost 3 months, and I am already trying to figure out how to fix this. One side looks gaunt with a high cheekbone and the other is round. Let me know if you find anything helpful...
Likely yours will go down a bit, but 10cc per cheek sounds like a lot. I remember I had 5cc a cheek the yr before my nightmare began. But I think you're lucky that it's only those 2 areas-at least it's easier to isolate that way.
If I was u, I wouldn't bother with your ps if he doesn't 'get' it. Maybe speak to a 3rd party for an impartial view. Has your ps offered a solution to you if the fat doesn't deplete? Is the issue just that it's too big or can u see the graft?
For removal- have you considered laser lipolysis to the cheek?there's a device called acculift that liquifies fat and is designed to use on the face. I think it sounds promising and would be interested in trying it myself. Im thinking of purchasing home ultrasound machine and booking myself for acupuncture and rfrequency treatments.
The 'quack' therapies I'm thinking of doing at the same time for a month or so:
-ultrasound therapy (apparently breaks up internal scar tissue)-home device
-serrapeptase tabs (same)-scar tissue therapies give hope for lumpy cheeks
-anti water retention tabs (some of the fat is squishy in my face and always blows up In the morning)
-juice diet (less food, less fat)
-deep tissue massage and facial exercises (although on the flip side, I've heard that this can increase circulation and theoretically promote good blood supply and fat growth!we'll see...)
-radio frequency (likely the most effective; could resort some fat unevenly, so therefore is a good job that my injector was a $&@? And didn't inject any of it evenly in the first place).
Also, there are 5th injections with microlipo. If u search for good facegonebad's review, she underwent this course of treatment. I think my areas are too large to just do this though. I'll be doing microlipo with rf probably, maybe a combination of treatments to achieve the desired effect.
http://www.realself.com/question/ulthera-correct-puffy-overfilled-cheeks-years-after-fat-transfer
It seems that it will tighten the skin, but not really reduce the fat? Not sure about this because other links say that it will help...
This is the link I was referring to... promising. Would only test a small area first, but I've seen YouTube vids, and the surgeons can literally see the skin and fat layers onscreen!
Leif Rogers also wrote on here about removing fat grafts:
"One additional technique that would most certainly work is Ulthera. Ulthera is an medical device that utilizes ultrasound to coagulate tissue in the layer under the skin. It is very will controlled in it's energy delivery. The only drawback is expense and the likely need for multiple treatments. It would most certainly work however, and without surgery or downtime."
Bad thing is-2000usd a treatment full face when I checked. Also that fat may dissipate unevenly, but Id say it's about as safe as microlipo, maybe better if you think about how tunneling deformities can be created via that method.
Rf treatments are the only certain non-invasive way of removing face fat.
Ulthera is essentially a more precise/controlled version of thermage as it utilizes ultrasound alongside RF waves (many ppl ended up with dents and depressions in a thermage pattern grid in the early days). You can control depth with thermage but couldn't actually visualize it.
Dr Shelton recommended thermage (or at least threw the idea out there) at higher energy settings for a poster who wanted to reduce fat transfers to the face, so it seems strange that he'd caution against Ulthera when it's essentially the same thing with the same "promise" as thermage. Obviously you'd have to use higher energy settings with either of them, but the good thing about ultrasound is that the layers could be seen onscreen, so less likelihood of dents and irregular dissipation if a good practitioner/conservative approach was used.
Anyway, I think for now I'm going to try the more conventional methods for the next month that I mentioned earlier. The worst ghat could happen is nothing. I'm ordering my supplies over the next few dys and will get it all together -gotta get going with my "trial"! The ultrasound home use machine will be the most expensive - I wonder if I can find any tutorials or DVDs on deep massage too. I've kind if discounted the acupuncture theory(might just get out a 1.5mm derma roller instead, lol) but do you think there's anything else to try that you've heard of?!
You have done your homework and have described well the alternatives and risks. One additional alternative would be risky as well, and that is trying to utilize Thermage with the original higher energy protocols. There had been some reported cases of fat atrophy and if the device were used off-label in this regard to create atrophy of your fat, it might give you a satisfactory result. The reality is that the Thermage would not be that easy to control and if you develop atrophy it... more
Ronald Shelton, MD
Manhattan Dermatologist
Yup, the lost social life energy has been directed elsewhere! I wish you all the best for your Drs appointment and be sure to check back with the feedback you received. Avoid the old photos until you've got a promise of resolution;) I'm sure your situation can be helped.
Just be careful on doing any removal. I was overfilled and basically effed up with FG done by a doc in LA who like yours didn't listen. I did 2 FG sessions. I looked very unnatural with big overstuffed cheeks that were very asymetric. Plus, it deeply hollowed my eyes.
I tried the 5fu a little. I think the important thing with me was just time. It really started to absorb after about a year. Most of it is gone now at 2 years out thankfully. However, it did some damage to my face. Most notably visible canula tracks and loss of natural volume in the area grafted. Plus, the skin isn't as taught. Stuff you won't experience unless the FG goes away.
I know some here have done the micro lipo (goodfacegonebad) with some success. My concern is the mechanical process of removal with a canula could cause other problems. Especially under the eyes where everything is delicate. Irregularities under the skin basically. Problems you might see in certain mirrors. Of coarse this is just my opinion.
I've talked to someone else who did the whole gamut of trying to remove a previous FG. She did the 5fu at first with Dr Hoenig. The 5fu had side effects though. Then she tried the microlipo twice. It mostly worked but you can't use it around the eye area though. Plus, it has down time like any surgery. So recently she opted for a technique of electric cautery from Dr Frederik also in Los Angeles. She said it was definitely the biggest difference with just a single treatment. Plus, she said it had allot less down time.