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.

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

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.  

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

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.

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.

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.

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.

Hi,

I would go with 5-FU.  I almost never use steroids.  The risk is too high.  The authority in 5-FU injections in LA in my opinion is Jonathan Hoenig.  He is a friend of mine and was on my panel for fat transfer last month.  He taught me how to use 5-FU, and it is wonderful.

It sounds that you may still be swollen, but the key to good fat grafting is using the proper technique. If fat is harvested with normal liposuction cannulas, it will often be lumpy. As the inventor of the Viafill system, I am proud to say that I have had very few complaints of lumpiness.