Fat grafting revision - what are my options?

It is not possible to give you accurate assessment and advice without in person consultation. This is very difficult problem to deal with and for that reason you need to discuss that in person with a board certified plastic surgeon, with long experience with facial fat grafting. Good luck.

Removing individual particles of fat necrosis is best done with with open excision. If the lumps are close to the skin then sometimes we can make a tiny tiny incision, pull up the lump of fat necrosis and put in a tiny stitches that tend to heal without a significant scar.
Each provider will have their own technique. Just need to find a quality plastic surgeon. Removing fat necrosis really doesn’t have much to do with being good at fat grafting other then they may have had patients in the past who developed fat necrosis. Regardless I suggest having multiple in person consultations with local board-certified plastic surgeons who have experience and seem to have a good reputation. Continue having it consultations until you feel comfortable you found the right one.
If it all possible for them to show you before and after pictures of previous cases that would be great but don’t count on anyone having lots and lots of them.
A lot depends on exactly where and how deep the problem is.
Best,
Mats Hagstrom MD