Hard Lump After Fat Graft Removal

I am 3 months post fat graft removal by excision. However, I now have some hard lump in the area where fat used to be. Should I get steroid or 5-FU on this lump to help the remaining protrusion? Does anybody know a doctor in LA who specializes in this?

Doctor Answers 12

Hardness after fat graft removal

There could be many reasons for the hardness after fat graft removal, such as inflammation, fat necrosis, hematoma, residual fat graft, or scar tissue.  Three months is a fair amount of time, but I would wait longer (approximately 6 months) before trying steroids or 5-FU.  You can try massaging the area to help soften up the hardness.  I would like to have more information about the fat grafting.  1)  What is the location of the original fat grafting? 2) What was the reason for the original fat grafting? 3) How was the fat harvested? 4) Was the fat injected or placed directly in the area? 5) What was the reason why the fat graft was removed?

The cause of the hardness can be better determined if the above questions are answered.  If the reason is scar tissue, then dilute steroid injections might soften up the hardness.  I would also caution that if the original reason for the fat graft was a contour abnormality, then steroid injections might worsen the deformity or cause an indentation secondary to atrophy of tissue.

A proper physical examination by a plastic surgeon who performs fat grafting would be appropriate.  However, if the hardness is not painful and does not bother you much, then I recommend waiting for another 3-4 months.

Glendale Plastic Surgeon
5.0 out of 5 stars 11 reviews

The hard lump is not uncommon and can be due to inflammation

The hard lump is not uncommon and can be due to inflammation. Fat is important for many things in the body among them: keeping the body from losing heat, serving as a lubricant of sorts for muscles to move, cushioning the body, etc.  This lump is not out of the ordinary with inflammation that can still be present after 3 months.  Steroids are an option.  But waiting is another option as well.

If in doubt do nothing unless it is urgent.  Waiting another 3 months is prudent to see if it is inflammation and maybe it will look and feel better.  If it has not gone down you could consider steroids to soften up the hard feeling of it.  It does help to see the lump as well and hence having your physician examine the lump would be the first thing I would do.

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.2 out of 5 stars 84 reviews

Hardness after fat graft removal

Hardness can be so many different things. It could be inadequate removal to scar tissue jsut to name a few.  You really need to be evaluated before suggesting a treatment.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Hard Lump After Fat Graft Removal

After fat is remove from the body via liposuction or by direct excision it will result in scar formation. The area of hard lump is simple collagen deposition(scar tissue). This is normal and it will take several  months to one year  to disappear.

Jaime Perez, MD
Tampa Plastic Surgeon
4.8 out of 5 stars 75 reviews

Removal of a fat graft by excision commonly results in temporary hardness of the tissue.

Removal of a fat graft by excision commonly results in temporary hardness of the tissue. This should resolve in time but may be accelerated by dilute injections of triamcinolone. Anyone with this problem should see a physician who is an expert in fat injection since improper treatment may makes things worse.

William P. Coleman III, MD
Metairie Dermatologic Surgeon
3.5 out of 5 stars 2 reviews

Steroid Injections First

While lumps after fat transfer or removal are not uncommon, it can indicate many things and may resolve over a longer period of time. I would start with steroid injections first as these are well tolerated and have minimal to no systemic side effects. If that does not work, you can consider 5-FU injections.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
3.9 out of 5 stars 14 reviews

Hard lump in donor site

hard lump present in donor site 3 months after is not common.  you should see your surgeon to discuss posibilities

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Fat injection complications

I am not sure what the reason was for removing the fat graft.  Were there any lumps?  Or was there a bulge due to excess fat?  If there was already a hard lump you might have had some fat necrosis.  If there was excess fat then removing it could potentially cause scarring in the area presenting itself as hard lumps.

In any case, it is important to allow the time for the remodeling to happen.  Intralegional steroid injections could be helpful in speeding the process, but it has to be done judiciously and in low doses to prevent tissue atrophy.  You should discuss these options with you doctor, but don't forget it is extremely important to wait six months to a year before any other intervention.  

Farhad Rafizadeh, MD
Morristown Plastic Surgeon
4.9 out of 5 stars 47 reviews

Hard lumps after fat grafting

Fat grafting is an excellent and effective technique to recontour the body. During this procedure, we perform liposuction to different portions of the body and then clean and processed the fact that we collect. This fat is then injected strategically to help recontour the body. It is very important to inject the fact in very small droplets so that the body has a chance to surround fat with good and healthy blood vessels. If this does not occur, it is possible to get a collection of hard tissue which may be a sign of fat necrosis. At this time, it is best to follow up with your surgeon so that they may assess this area and determine is anything further needs to be done. They may elect to use warm compresses on the area to help break up this tissue or if they consider this to be a collection of fluid, they may recommend aspiration or drainage of the site.

Pat Pazmino, MD, FACS
Miami Plastic Surgeon
4.7 out of 5 stars 101 reviews

Many different causes for hard lump

This may be residiual fat necrosis or a resorbing hematoma or other source of fibrosis. Of course it could be a variety of other cuases. I would consider starting with intralesional steroids such as triamciniolone as an initial step. However, I am certain that your surgeon is familar with this option and may not want to use this for a specific reason

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 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.