Facial grafting with minimum injections in chin. Is this normal? (photos)

Mother injected her own liposuctioned fat which has been in the hospital freezer for 6 weeks in the chin lines. She was fine the day of, however woke up extremely swollen, redness & tenderness appeared and had fever the whole day. The doctor said it's normal & asked her to continue taking her antibiotics. In all my readings never did I find a fever reaction. Also what about the redness? Today Day 2 post op, she's asymmetrical with the swelling but the fever has subsided.Could something be wrong?

Doctor Answers 6

Fever and redness after injection of stored fat graft may be cause for concern

The difficult thing here is that the symptoms you are observing are all rather "nonspecific" signs of "inflammation," and there are a number of things that can cause an inflammatory response in tissues.  Inflammation is basically the body's way of responding to some kind of injury or "assault," whether it be by mechanical trauma (a punch in the eye or surgery or injection), infection with bacteria, virus, or fungus, some kind of chemical insult, or something else.  This happens because injured cells release a bunch of chemicals that are collectively called "inflammatory mediators."  This is the key to how aspirin and NSAID drugs (Non-Steroidal Anti-Inflammatory Drugs) work to relieve pain and inflammation.  They block the formation of certain of these "inflammatory mediator" chemicals that our injured cells release, thereby lessening the inflammatory response.  Thus, things that comprise the inflammatory response, like redness, swelling, pain, tenderness, fever or heat at the inflamed area, are decreased.  This doesn't necessarily do anything about the CAUSE of the inflammation, but it decreases the symptoms.  Sometimes it is important to do this because inflammation itself can cause further tissue destruction, even though you might need to also treat the cause with something else.  So, if the inflammation is caused by infection, for instance, you would also need to treat with an antibiotic to kill the offending bacteria.  This is a lot of background information, but it is important  to understand my answer here.  

The things that you are describing can be due to either dead fat cells in the stored fat which have ruptured and released their "inflammatory mediators" into the "pool" of graftable cells and then were injected along with the graftable fat cells, bacteria that has grown up in a stored graft, bacteria introduced during the procedure, or simply to injury to the tissues during the procedure, which can be a "normal" part of any fat transfer procedure.  We usually expect some degree of swelling, bruising, and inflammation from any fat transfer procedure.  Most of that would be expected to settle down on its own as the body takes care of inflammation and heals, and any bacterial sources of the inflammation would normally be treated with antibiotics, which it sounds like your mother's doctor is doing.  It sounds like she is responding to thet treatment, too, so based upon what you report, no change in that course is indicated at this time.  At this point, it is very early to assess things like swelling and symmetry and contour.  The best course of action now is to stay in close contact with the doctor, advise him or her of any changes, and allow the tissues to heal.  Usually, as long as any conditions that might progress if left untreated, like infections, are treated, the worst case scenario is that the procedure doesn't work and we are left with no improvement or irregularity in contour because of partial "take" of the grafted fat.  In any event, your own surgeon will be the best to evaluate that and recommend any further action if necessary.  Good luck.

Swelling and redness post fat transfer

Swelling and redness after facial fat transfer is the norm especially in the first few days.  Generally, the swelling and tenderness should start to resolve quickly.  Infection is a risk from any injection, slightly more so from fat transfer; however, these generally occur later than the first few days.  It is important to follow your post-op care instruction and follow up with your physician if you have any concerns.  

Kyle Coleman, MD
New Orleans Dermatologic Surgeon
5.0 out of 5 stars 7 reviews

Facial grafting.

Thank you for your question and for sharing your photograph.  I would be concerned about these reactions, especially with placement of 6 week old fat that had been maintained in the freezer.  Your body is likely having a reaction to this fat that will likely not survive.  See your surgeon for an in-person evaluation.  

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 38 reviews

Concernes after fat transfer

You are in the very early phases of healing and your doctor should be available to you - send him pictures if you have to to evaluate the area. 

Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 73 reviews

Facial grafting with minimum injections in chin. Is this normal?

It is very difficult to give you a recommendation with the pictures provided and without a facial exam. I suggest that you call again your surgeon and try to see if she can be evaluated ASAP. This is always a safe way to treat this problems.

Hope this helps,
Dr. Gus Diaz

Gustavo A. Diaz, MD
Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 15 reviews

Infection after Facial Fat Grafting

i assume that this happened out of the country, because I am unaware of any US hospitals that will store a patient's fat for 6 weeks? Hard to diagnose without physical exam, so I recommend that your mom see a board certified plastic surgeon right away. Good Luck!

Robert M. Tornambe, MD
New York Plastic Surgeon
5.0 out of 5 stars 23 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.