Lower bleph fat transfer fixable? (Photo)

Question

6 months ago I had lower face lift with fat transfer to face including my upper and lower eyes (+ laser resurfacing around eyes) My surgeon is an excellent one with much experience and highly recommended. I’m extremely unhappy with the divots and bumps in my tear trough area. One week ago my surgeon injected a steroid as a first attempt to correct. What are my options? Is this permanent? My faith in my surgeon has been shaken and now I would like other professional opinions on my options to fix

Nelson Lee Novick, MD · Answer

I'm sorry you are having this problem. It is for reasons such as these that I personally gave up using fat transfer many years ago. For one, the promise that the fat is a permanent solution is seldom fully realized, since much of the fat displaced from its original blood supply does not survive. What's more, the fat that does survive retains the characteristics of the donor area from which it was taken (belly, thighs, abdomen), so that when these areas undergo "midriff bulge" the same may occur in the recipient location. I have personally had experience managing fat transfer complications in patients who have been treated elsewhere via the use of subcision to mechanically break up the fat deposits along with varying amounts, combinations and concentrations of intralesional steroids+/-5-FU+/-hyaluronidase. Make sure that you consult with a board certified cosmetic dermatologist. Once again, sorry. Hope this helps.

Kenneth D. Steinsapir, MD · Answer

I do not agree with a direct incision over the lumpy grafted fat. Unfortunately this approach can leave a scar. I strongly do not agree with the use of steroids into the eyelid. These drugs cause permanent damage to the natural fat and seldom resolve the lump. There is no substitute for a detailed in person assessment.

C. Blake Perry, MD · Answer

Steroid/5Fu injections are good to help with any inflammation and scarring issues. Unfortunately, problems with fat transfer usually become surgical fixes. Incisions are typically made over the areas of lumps and excessive fat is excised. Fillers can try to disguise any contour irregularities.

Lower bleph fat transfer fixable? (Photo)

Answers (3)

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