Facial Fat Transfer for Under Eyes hollow. Is this common to remove a cheek implant or should graft be done over it?

I'm considering facial fat transfer for under eye hollowness. I've read time and again that the fat reabsorbs and it is a risky procedure. Have there been advances in the past 5 years that have made this procedure more reliable and longer lasting? Also, I have had cheek implants in the past and during a consult a doctor said he would prefer to remove the implants and just work with fat to give a better result. Is this common to remove an implant or shouldl the graft be done over it?

Doctor Answers 4

Safety First

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Fat injections are commonly performed for correction of contour deformity in the lower eyelid, where it meets the cheek. Surgeons use a fat harvesting technique, and method of fat preparation, that works for them. In the circumstance of a previously placed cheek implant, it may be best to avoid injection near the implant. It would be unfortunate if the implant became infected after injection, so avoiding this possibility all together seems like a better option. I recommend consultation with a Plastic Surgeon certified by the American Board of Plastic Surgery.

Facial Fat Transfer for Under Eyes hollow. Is this common to remove a cheek implant or should graft be done over it?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Fat transfer is a very safe procedure in the hands of a board certified plastic surgeon.  Precise placement of the fat graft with proper technique and amount is paramount in achieving the desires result.  I would not typically remove a cheek implant before placing a fat graft unless it was causing a deformity of the face that could not be overcome.  It is difficult for me to advise without photos.  I would get a second opinion and go with the surgeon that you feel comfortable with.  

Jason Mussman, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 3 reviews

Fat Transfer

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Fat transfer to the face is common and generally safe procedure done by a board certified plastic surgeon.
The fat has to be suctioned by micro cannula and transferred by a blunt cannula to prevent accidental intra vascular injection. Some of the fat will absorb. It will look very puffy after procedure because of swelling. There is a possibility of lumpiness. May need more than one session.  If you are happy with the implant in the check then you can leave it in.

Samir Shureih, MD
Baltimore Plastic Surgeon

Facial fat grafting

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thanks for your question.  There has been some advancements on how the fat is processed with early research showing a higher rate of retention of the fat transferred.  This has made it more reliable.  
It's hard to really answer your second question without seeing pictures or examining you but I would say that it is common to remove the implant and graft instead to give a more natural result.  
Good luck on your surgery

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.