I had a lower bleph with fat transfer 2 weeks ago. I am worried about the results, including lumps and festoons. (photos)

Hello,This soon after surgery you can expect to have swelling and some contour irregularities due to the fat placement/swelling/sutures. I recommend that you follow up closely with your Plastic Surgeon and ask them what they advise for safe treatment at home as you heal. they can examine you to rule out any issues and ensure that you are on track. Hang in there

Your lower eyelids are still swollen from the procedure, fat transferred and sutures used to hold them in place. Beneath that you have malar edema or swelling over the cheekbones. Both of these issues should get better over time. Follow up with you surgeon because there are some safe things  they can show you to do to speed your recovery. Heat is not a good idea at this point.

However, they can damage the healing eyelid.  Speak with your surgeon before torturing your poor eyelids.  I see 2-3 new consults each week regarding unsatisfactory lower eyelid fat grafting.  I personally think this is a very difficult technique.  The grafted fat is inflammatory and causes scaring and irregularity.  Festoons are common.  Time is very helpful here.  Be very careful about steroid injections which can cause unpredictable skin and fat atrophy.  I also think you are going to have a lower eyelid contour issue.  Generally it is best to wait 6 to 12 months before considering revisional surgery.

First and foremost, I am sure the procedure was performed in your best interest. Time and benefit of the doubt should be provided to your surgeon. At two weeks, you are way too early in the postop recovery period to even begin assessing final results. Give it time, hang in there, and refer to your surgeon for recommendations on massage. Without an operative report to refer to, I would be remiss in offering recommendations on massage treatment.

Your own surgeon is your best bet since only he or she knows details of your operation and realistic expectations from it. Fat grafts have unpredictable behavior with no guarantees.

Hello KWH,At this stage you are still very swollen.  In addition, the fat repositioning leads to even more swelling.  The hard knots are likely sutures that were used to help reposition the fat in the new location and should improve with time.  Your eyelid are showing some malposition but I would attribute that to the excess swelling at this point.  You should consider talking to your surgeon as sometimes we will initiate massages at this point to help get the eyelid into a better position before the scar tissue sets in.  I hope this helps and good luck.

Luckily those are not festoons, just some swelling. Give it time it will continue to get better. We almost always overfill the fat when we transfer because 50% of it goes away. That take a couple months for it to "shrink". And absolutely go see your PS with any issues. 

Thank you for sharing your photos.  You are still early in the healing phase following your surgery and fat transfer.   The lumpiness may be due to early stages of scar formation.  The festooning is due to lymphatic drainage disruption leading to swelling.  Please visit with your surgeon before massaging or adding heat. Best of luck,Suneel Chilukuri, M.D.Houston, TX#fattransfer, #blepharoplasty, #lidsurgery, #teartrough, #festoon, #knots, #lumps, #saggylids, #eyelidbags, #RefreshDermatology