Should I Be Concerned with Eye Bags or Puffiness After Fat Transfer?

Question

Two weeks ago, I had fat transfer/fat grafting on my under eye area-primarily on the area at the corner of the eye. This was suggested to me by my doctor who showed me how it would give my eye a nice contour. He also showed me many photos of patients whom he had done this procedure and I met two of his patients in person who had great results.
Two weeks after my procedure, a lot of the swelling has resolved and now I have big puffy bags under my eyes. They also appear to look the same as they did one week ago which makes me think what I am left with is just fat and not swelling. The under eye bags are soft to the touch except for one area that is a little more puffy and has some tiny, soft lumps under it. 
While I am confident in my surgeon, I am concerned that I may not have been a good candidate for this procedure, and these under eye bags were never mentioned to me as a possible side effect. In fact, the only information I have found about under eye bags created by fat grafts appear to be the result of fat grafts gone wrong. Is this a common side effect or do I have cause for concern?

Sam Naficy, MD, FACS · Answer

Soft bags after fat grafting are likely festoons (malar edema).  This is common and will resolve over time.  Sometime steroid injections help speed up the resolution

Sanusi Umar, MD · Answer

Swelling and puffiness are not at all unusual. You want to make sure you are just getting your rest and healing up appropriately. Fat grafting is a delicate process, and it's imperative that a patient takes the utmost care in healing themselves.

	Healing up after a fat grafting can take over three weeks.  The best thing you can do is communicate with your surgeon about any irregularities you may notice. Do not be alarmed by swelling and puffiness though, especially around the eyes, as this will soon go away. Gentle massaging will definitely help speed things up a bit, but over all, just be patient.

Edward Buckingham, MD · Answer

You will not know the result of your fat transfer for 6-12 weeks. Two weeks is much too early to know the outcome and it is usual and expected for there to be bags under the eyes in that time frame. If you trust your surgeon and he/she has good results you likely will too. Be patient, it will be worth it.

Pat Pazmino, MD, FACS · Answer

It is common to see puffiness and swelling in the area of the lower eyes after a fat grafting technique. When we perform this delicate procedure, keep in mind that a small amount of volume will go a very long way. After such a procedure, patients should expect to see significant swelling and puffiness. They will see their final result in 6 to 8 months after surgery. At this time, it is best to place cold compresses on to the area and keep your head elevated. This will help with the resolution of the swelling.

Reza Nabavian, MD · Answer

Fat grafting can take longer than two weeks to stabilize.  Your surgeon should be able to advise you if he thinks your progress is within the norm.  Slight irregularity and small bumps may be a transient process.  I generally ask my patients to tape and massage the area.
If a patient has persistent irregularity or bumps after waiting a reasonable amount of time, then you can consider revision.  Persistent areas of scarring after surgery may respond to corticosteroid injection.  Persistent fat bumps can be considered for removal, either directly or through small cannula suction.
It sounds like you are under the care of a competent surgeon who should be able to advise you properly.

Should I Be Concerned with Eye Bags or Puffiness After Fat Transfer?

Answers (5)