“FAMI "Stem Cell" Graft - Marbella, Spain”

That's the point. The surgeon and his staff don't admit their mistakes. An apology would go a long way to soothe the regret over doing this whole procedure but they just continue sticking to their lies about stem cell grafts and how they cannot cause excess growth. Well then, how come they decrease and increase with weight loss or gain. Obviously, stem cells would not behave this way, but fat cells do. This is described by many other people who have had traditional fat grafting performed........and yeah, it REALLY sucks.

I just want to warn others who may be considering this procedure to be extremely cautious about this surgeon and his technique.

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How did you end up with 2 holes in the middle of your face?!

Hi, I am being treated by Dr Amar and although I am not well yet.....things are improving and I feel confident. He was the first one (after several failure surgeries by other Doctors who use lipostructure instead of FAMI) to make things well.

I am happy with Dr Amar. He is helping me. Why dont you ask him to fill in the depressed areas?? I know he has treated a patient called Carmen twice since I viewed a video of her second FAMI and he treated me twice already......I guess it is MUCH better filling afterwards a bit more than being overfilled and with lumps.....Take care,

colour, I am guessing you are from Spain. I would like to hear more about your experience with Dr. Amar. I was very interested on it but I was sort of disappointed I couldn't find reviews online from patients, other than his own website. Then I found Badfatgraft and his experience turned me off. If you are willing to share your experience wether on public or private I am eager to know more about it.
Thanks (BTW I am from Spain)

Hi Siona, I am not finished with my FAMI treatment.Therefore I cannot show you my pics till I am cured. Sorry for that. Hopefully you undnerstand. Take care.

My heart goes out to you as I'm in a very similar predicament to yours and Patricia's. I'm overfilled in the subcutaneous layer, plus some muscle layers, all in the midface. It's just devastating.

A deep place facelift can be done to remove fat in the muscle layer or reposition it (I wish I could do this but I'm too young). How far out are u from the grafting? If you're not too long I'd try ultrasound therapy asap and vigorous massage.

I once read Amar stating his method lasted for 5 years - maybe some hope? His publications are available online so you might want to check it out and find some answers.

People are being ruined by this craze (that's the best way to describe it) - I lost my beauty and looking in the mirror is so hard. I stopped going out etc. I'm considering starting up a blog online, to help inform others and provide support for the overgrafted. I'm not against FT but am against the misleading ways it's being marketed to a vulnerable public.

"The grafts do not rebuild bone, muscle or anything else"
"respect the natural contours of each individuals unique facial structure"
These two points are spot on - buyer beware. Implants are for restructuring. A few years ago, there was a public outcry against a well-known PS in NY, who disfigured patients beyond recognition by using fat in this way.

I'd add another few points:
1) Fat does NOT feel natural beneath the skin, unless it is barely perceptible. It can also discolour it and hardens if injected too superficially. The broken veins patricia mentions are symptomatic of this.

2) Body and facial fat are different. Body fat is tougher and more fibrous so people need to consider whether they'd feel comfortable with having restylane injected throughout their faces (no) - why do the same with fat?

I am due to consult with a surgeon in the US to remove some of the fat once I can.

Sorry to hear about all this you're going through, quno. I am also fairly young and removing fat from the deeper structures of the face is quite a challenge. Nothing is impossible, but pulling something like this off successfully is not easy and i would imagine few surgeons would want to take on such a difficult case.

Fat in the subcutaneous layer of the face can be removed with micro-liposuction, from what i have come to understand. Although if done too aggresively, it can leave behind unsightly dents and/or broken blood vessels.

On his website, Dr. Amar claims his grafts last 10+ years. Very disconcerting news for me. But I have learned to not believe everything i read.

I myself did not experience broken veins with the FAMI technique as many of you have. The fat, surprisingly, does feel natural, theres just too much of it. I have one fairly large nodule in my lower left cheek near the jaw, but it is not noticeable, i can only feel it when i press down on it with my fingers.

I agree 100% with you on your 2nd point, quno.

I wish you the best, quno, in your efforts to remedy your current situation.

badfatgraft,

The subcutaneous layer fat is very thick, but diffuse throughout my midface. Unfortunately not in lumps - so can't all be seen from the outside. I'd have to find someone willing to perform general facial lipo to destroy the fat..

Does Dr Amar back up his claims with scientific studies?

Realistically there's no way to know how long fat transplanted will last. I personally think it's permanent when large amounts are done, and when it's injected into muscle it's apparently longer-lasting.

Considering your cheek situation (and mine), I read on another forum of a patient who was considering Dr Y in Boston to get her fat graft out of her cheeks. He'd offered to cut the fat out whilst performing an MFL. Apparently, he works on the deepest plane so therefore should be able to access the FAMI fat. I'm going to check him out.

I think the younger you are, the more of a disadvantage you find yourself at when you go to try and correct things though. I've only consulted with 2 surgeons so far and they weren't entirely successful. Many are reluctant to employ endoscopic/facelifting techniques on younger patients as they're not age appropriate per se - but too much fat is NEVER acceptable at any age! Mine's so bad that I'd do anything to get rid of it. I was shooed away by one of these surgeons on the basis of age alone and not because I have a problem, which he recognised in consultation but played down. I haven't consulted the fat problem experts however, so there's still hope yet.

Also, not appearing grossly deformed to the objective onlooker means that surgeons are less willing to help you, even though - ironically - they'd only be able to do so much in that kind of situation. I feel that if my surgeon had made me look even more ridiculous then I'd have found someone to help by now.

I think that they should rename fat transfer 'face transplant' as patricia referred to it - the sense of lost identity is disorientating.

I wish you the best of luck too.

When fat is grafted or transferred to any part of the face, it must find a healthy blood supply to begin "feeding" off of after it is injected, otherwise, the transplanted fat will die and be reabsorbed by your body.

If you are sure that your fat was placed into the subcutaneous layer, do you mind me asking how long ago you had your fat transfer done? It may still reduce in volume and blend in somewhat up to 18 months or so after your procedure. According to some "experts", fat has to be placed in very small quantities for all of it to survive. If large globs or too much fat is grafted into areas with poor vascularity, most of that fat will dissipate and dissapear with time. Scar tissue may be another issue altogether, that may be resolved to some degree with other solutions.

Dr. Amar has scientific evidence based in part, on his own personal experience, to validate his claim that fat survives better in tissues of high vascularity such as muscle. Although other surgeons may dispute this. His claims that fat tissue contains high concentrations of adult stem cells or mesenchymal stem cells also appear to be supported by current scientific research studies. However, the claim that these progenitor stem cells can turn into or "mature" into other types of specialized cells, such as bone or muscle or actually repair damage due to injury or trauma to any of the structures of the face or the skin, is not proven. It is his theory. A poorly devised theory based on incomplete or insufficient data and lack of long-term studies. You can read all about his theories, which he elaborates on, on his website. Most of his beliefs are unfounded and largely unsupported by the mainstream medical community due to the lack of clinical evidence and the fact that his ideas are unproven.

On the positive side, quno, it seems that maybe you and i should be, at least a little grateful, that we are not "grossly deformed" enough to easily be able to find a surgeon to help us. We'd have a whole set of other problems if that were the case.

Hello, sorry I didn't see your reply a bit sooner. It's been almost a year since the fateful day. Some of mine has gone down very slightly, although unevenly, and it still feels like my face is glued together.

This, along with yellow discoloration, tells me that fat's been placed between skin and muscle. I can feel the fat tethered to my skin when i pinch with my fingers, rather than just a palpable (or imperceptible to the touch) mass underneath. It's heavy and causing a degree of distortion around the mouth/mid face.

I think the question of scar tissue is most concerning and there's a lot of conflicting info out there about this. Some doctors say that fat grafts have fibrous scar bands running through; others say fat becomes encapsulated within scar tissue and some refute this claim entirely. It's hard to get a firm answer on this and would probably be worth asking facelift surgeons about the behavior of grafted fat when moved around through an open incision.

There also the question of removing fat-a lot of surgeons say removing fat transfer is very, very difficult, yet I've also come across assertions that grafted fat is more vulnerable to trauma and easily disrupted. This ties in with what you say about blood supply-I wonder if the fat parcels act like parasitic adhesions?! Surely some kind of pressure or trauma could help-maybe washing line pegs or elastic bands applied strategically to cut off blood supply? Lol. But seriously, I've seen the occasional doctor on here recommend lymphatic drainage and ultrasound-I wonder what effect either treatment would have on blood supply.

You mentioned in another earlier post that your fat transfer went down at the 4 mnth mark and came back in full swing after that- does that support general theories you've read about or was that simply your own personal observation? I've heard something similar from Dr Lam's forum, who supports the view that there's a dip, or something to that effect.

Yes, I read about doctors (Coleman) who say that fat turns into bone or muscle if placed in these areas, but I do agree that such 'evidence' is largely garnered from anecdotal observations and frankly, whatever fat 'feels' like or 'becomes' may not be related as much to the recipient site as it is to the characteristics of the fat itself.

Amar seems like a very effective self-publicist and has had the fortune to be published with regard to fat transfers. I believe Drs who overfill like he does should be working in a lab, not in a cosmetic surgery practice!

The 18month timeframe gives me some hope. Which areas of the face (or placement depth) have less vascularity? Were you told this by Amar?

I usually hear of people losing all their ft within 3 months (or very early on), or on the contrary, keeping it for ages. It would be interesting to hear from people who noticed depletion of fat at a 1yr or 2 yr mark, etc.

I wonder if ultrasonic waves would have any effect on scar tissue at this late stage for either of us, or whether we'd have had to have done that earlier on. It's a dirty trick for Drs to tell us we'll be swollen, so that we miss the time period when action (devascularising fat via deep massage) would be possible.

Yes, we're lucky we still look normal, but in a way that makes Drs less reluctant to try and fix an issue that isn't glaringly obvious at first sight.



Have you noticed any improvement since 2 years ago? You mentioned in an earlier post about the fat going down, then coming back again,

My experience with the FAMI procedure had a considerable amount of swelling for the first two to three months, then, all the swelling completely went away after that and the result looked amazing. It looked like i had hardly had anything done. The sunken areas on my cheeks that caused me to go have a fat graft done, looked amazing. It did not look too full, it looked very natural and I was so happy. I even wrote an email to Dr. Amar telling him what a great job he had done and thanking him. This great result lasted for about three weeks and then my face got "swollen" again. At first, I thought it was the edema that had returned, but then i remembered that Dr. Amar had told me that the result of the FAMI procedure would seem to go away and then would return shortly after it seemed to go away.

During that time where I was searching for answers, I stumbled across Dr. Lams website where he describes the exact same thing with his fat transfers. It appears that the fat cells shrink in the first few weeks to months after the fat graft and then grow in size. He calls it the "dip", just like you say. My "dip" happened just as Dr. Lam describes, right down to the timeframe after the fat graft that he expects his patients to experience this "dip". No one really understands or knows why this happens. Dr. Lam does not claim to isolate stem cells from fat and inject them into your face, he simply calls his procedure a traditional fat graft. This is what helped me understand that Dr. Amar isn't doing anything special or unique with stem cells, because he gets the same results Dr. Lam claims to get with his fat grafts. Dr. Amar just puts the fat cells into muscle, where Dr. Lam does not.

Coleman patients are the ones that i've read about that have had their fat grafts slowly dissipate after two to three years, leaving behind sagging skin and scar tissue.

Fat that is not placed deep and in large globules seems to have the least chance of survival. Fat placed just above or into the muscle seems to survive the best because it survives from the nearby blood vessels that feed the muscle.

I think it'd be worth a try to try to disrupt the fat applying the pressure application techniques some recommend. I think you would have to be very consistent, though, and do it pretty often like Dr. Amar suggests to the person with the overfilled lip. I mean, it cant hurt to apply steady and firm pressure for several minutes a few times a day for two weeks or so being careful not to hurt yourself.

I guess what happened in your case (and mine) is that the surgeon overfilled by 50% at least, in line with some duff principle or 'average retention rate' study they'd learnt from a journal article or invented themselves. I am beginning to think that surgeons haven't managed to "connect the dots" with regard to fat transfers; they see patients for the treatment, the patient goes away and never returns; if they do, then the follow-up always assumes an aesthetic appreciation of the situation rather than any real attempt to determine causal factors when a patient retains all the fat and/or appears overfilled. There seems to be a lot of blame placed on individual patients' biology, but I really am beginning to think there's more to the methodology used by individual surgeons.

When browsing questions on real self, every doctor says something different about fat retention, percentages, scar tissue, removal methods... It's the non-med school patients that are actually really communicating with others, sifting through information, trying to learn for themselves what the real deal about fat is. Even the docs are confused, which tells you a lot!

There seems to be an even greater degree of fear and misunderstanding about removing fat from the face. I'd attribute this to surgeons not being prepared with regard to layers (where the fat is), lack of formal training in removing facial fat, and the fact that removal techniques fly in the face of a very lucrative and powerful segment in modern plastic surgery.

I believe that this is why there's no interest in developing technologies that remove or can isolate certain types of fat.

Most worrisome is the assertion that fat can regrow in the face once removed... There are some who believe this, based on what evidence I don't know.

I wonder if the way that fat is harvested has any effect on results? Hiw did Amar harvest your fat and where did he take it from? Some surgeons just syringe it out; others (like mine) used straight liposuction, yet still say their method uses low pressure extraction. I think that there may be more in this connection between harvesting and grafting survival than we currently realize.

Yes, I read about the 'dip' theory on Lam's website: I was skeptical at first, but his photos do appear to support this. I wonder why this happens-do you have any idea? I can't say I noticed it happen in my case. I was just full for ages (if anything, I feel mine got bigger!) and only recently have I noticed that SOME has gone down, as I have more visible irregularities.

Apparently, Lam's method is almost identical to Coleman's, or so he states on his forum, although the volume he uses is far less (thankfully). I gather there are only a few surgeons in the US who really do use the Coleman method for fat, and I don't mean in terms of general overfill, but with regard to the time-consuming application of aliquots of fat.

I often had wondered whether facial exercise or pressure would work right now. It's certainly interesting (and ironic in your situ, as you said), that Amar recommends this method for removal up to 2weeks after the transfer has taken place. The question is: what happens in that 2wk period with the fat? Why does it take 2 weeks to establish a blood supply? Surely, if grafted fat cannot survive without a blood supply, then it would die instantly? Maybe these questions are stupid, but I really have wondered about this time signature.

These Drs are just all about the hard sell- Amar is just a medieval type quack who is intelligent and well-versed but whose work lacks an aesthetic touch. Lam is likely of the same caliber with 'his' method (he also claims to have "invented" a new type of facelift incision), although he does seem genuinely interested in studying the long-term behavior of fat in his patients as per his website (if only for marketing purposes).

How can you tell what's scar tissue and what's fat? I think that's a difficult thing, unless the area is obviously very hard or forms an obvious lump. like fat, there are different types of scar tissue - makes things very complicated!

What worries me is that areas with technically "poor vascularity" in me have been over injected with large globules (not supposed to survive), but are still there, and that people complain about fat grafts done years earlier, even on this site. I will certainly take your advice about pressure and massage - I would encourage you to do the same, maybe combined with facial exercises (vigorous working of muscles may even dislodge some of the fat from it's blood supply?! I know you can't spot train but who knows?!)

Coleman must be injecting LARGER amounts than he admits if you see the complaints board photos-how can big fat chunks represent small deposits unless the fat cells and scar tissue have somehow glued together?!

Well, I'll conclude and say that I believe our best hopes lie in 5 fu injections to reduce scar tissue, plus radio frequency treatments and ultrasound. Excision also. I really am not convinced too much by microlipo-the more I read, the more I don't feel it's all that...

I found an answer given by Leif Liu Rogers here on real self, about Ulthera, which he recommended to a poster for reducing facial ft:
"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."

I looked into it and I think it really does sound like a good bet, if one is conservative with the area, because the skin and fat layers are visualized on screen. Bad news is that it's very expensive!

Omg, that was the longest reply ever... I thought I'd accidentally pasted another copy, but no! :-o

So your dr is blaming your biological factors for havin stuffed your face with fat? Omg i guess it makes sense since i am sure he is telling everyone that he pushed on my lower eyelids because he was appreciating the aesthethic situation of damaging the fat graft and hurting me, ? Very daffy.

Yes, these are side effects that they never warn you about because they know if they do tell you about them, you will probably not go through with it. I understand how you feel.

You still have some swelling so dont lose hope. You may not have the final result for maybe up to eight months. Its a long time to wait, i know. You may heal differently though because you also had a facelift which can be more invasive. I'm sorry you're going through all this.

Things will improve. To what degree, however, no one can know for sure. But they will get better. Be patient.

Get yourself down to a derm or sports therapy clinic and try ultrasound therapy. Vigorous massage too. 4wks means you can stil; get rid of some of this. Wish i'd known.

Patricia - I live in London too. I'd wait a little while (a few wks-try the devascularisation method first if concerned) and get a second opinion from a fat transfer specialist in Europe or the US if these things persist.
There is a Dr Trepsat in geneva who comes highly recommended.

Hi patricia,

I think I can cheer you up! I underwent upper face FAMI and when I arrived home me kids could not recognise me and got scared to death when tey saw me. But the swelling goes away and the cute cheekbones stay! The swelling is necessary to get a final nice result. Thats what I can tell you. I hope things are improving. Take care + best,