Are Fat Grafts to the Face Reversible?

Question

I had a fat graph procedure to my face about 1 1/2 months ago. I was very specific about what I wanted yet once the surgeon had me under full sedation, he changed things and did what he thought was best. I ended up with a long skinny face as a result of orthodontic treatment involving tooth extractions. I am extremely unhappy so far being that he made my face very bottom heavy and the top still looks very skinny. Now my face looks even longer than before.

Otto Joseph Placik, MD · Answer

Fat grafts are difficult to reverse. Options include excision, liposuction, laser lipolysis, steroid injection, radiofrequency or ultrasound ablation or even mesotherapy. First gve it 6 months prior to intervening

Ron Shelton, MD · Answer

Much of your fat injections may reabsorb on their own. That's the problem with fat injections. There is no guarantee that they will live. If there is one focal area that needs to be reduced, then a small amount of corticosteroid can help, but there are risks and it should not be used when there is a generalized fullness that could be lessened as the risks would not be warranted. It may be that you will see an improvment in the next couple of weeks. Try to be patient and wait for the improvement as attempts to reduce the fat can cause irreversible problems.

Christopher V. Pelletiere, MD · Answer

Anytime a fat graft is performed, it can take up to 6 months or more before the fat is done changing, lysing, and taking hold. Some patients only have 50% of the fat left at 6 months, while others have all of it left. It is hard to predict how much will remain, since the fat needs a good blood supply to live, and sometimes the areas that it is injected to just doesn't have the capacity to keep all of the injected fat viable. Since you are only 6 weeks out, be patient. At the 6 monthmark, if you are still unhappy, then I would address it with your surgeon. I hope this helps.

Jason Hess, MD · Answer

Cranberry,

	Sorry about this outcome.  Fortunately (or unfortunately), only a portion of transferred fat survives following this procedure.  You may be witnessing residual swelling following this procedure that will hopefully resolve entirely within the next few months, if you are fortunate. Studies regarding fat grafting suggest that survival is from minimal up to 70% in its new home.  I believe it is less than 50%.  Thankfully, most procedures in plastic surgery are reversible in the hands of a competent surgeon.  Give it time.  If it doesn't resolve, first contact your physician and voice your concerns.  If you are unhappy with the options presented, see another doctor or two.  Microlipo may be an option depending on the location of the fat.  The face is extremely vascular and highly innervated, so any corrective action taken here must be performed with extreme caution.  Good luck!

Michael A. Persky, MD · Answer

Hi Cranberry (or is it Pear),

	Fat grafts are not reversible. Hopefully after 5 to 6 months your fat grafts will settle down.  It is most unfortunate when there is miscommunication between patient and surgeon, and more unfortunate if as you stated a surgeon decides what they think is best for the patient despite the patient requesting something different.  Your problem emphasizes the importance of choosing your treating physician most carefully, a physician whom you can trust to honor your desires.  At this point all that you can do is wait for the next few months to see where things settle.  There are other fillers such as Sculptra that can be used in the "skinny" top part of your face to help bring your face into harmony.  I wish you well.

	Dr. P

Sam Lam, MD, FACS, FISHRS · Answer

Although fat grafting is irreversible for the most part (facial liposuction is very hard to achieve good results), sometimes finding a surgeon who understands facial balance can help.  For example, if your face is too long, adding fat to the sides of the face can blend in the long look and make the face more of an ideal oval shape.  A consultation with not only a technically skilled surgeon but in my opinion just as important an artistically minded one can help you balance the face not by removing the transplanted fat but by judiciously adding fat in other areas to offset the look that you currently have.

	best,

	dr. sam lam
	facial plastic surgeon in dallas, texas

	p.s.:  the link to the video will help you understand my aesthetic philosophy regarding fat transfer.  i gave this lecture a couple of weeks ago in san diego.  :)

Barry L. Eppley, MD, DMD · Answer

At just one and half months after fat grafting, it is too early to consider any reversal treatment. It could very well be that by three to six months after the procedure, the problem may be self-solving if most or all of the fat resorbs on its own. If at six months after the procedure you feel the injected areas are too full, then injections can be performed to help resorb the fat. This can be either steroid injections or low concentrations of a lipodissolve solution.

Samir Shureih, MD · Answer

You are still very early to think of revision. You should wait 3-6 months before any revision.

	Fat grafts are very difficult to reverse. Some of the fat will take, some will not take.

	Work with your surgeon to harmonize the face and look at the before and after pictures once everything is settled.

	All methods mentioned may cause more problems and become more difficult to repair.

Carmen Kavali, MD · Answer

Fat is not a reversible filler, although portions of the grafted fat could be excised (but that would leave you with more scarring). Time is your friend, as some of the fat may resorb (go away) over the coming months. Without a photo, I really can't begin to guess what else might help you.

Richard P. Rand, MD, FACS (retired) · Answer

After 3 months, the fat grafts will have "taken" or not. So wait til then to see as much of what you now have may disappear. In the end, a surgeon has to use their judgement to do what is best for you.

Are Fat Grafts to the Face Reversible?

Answers (10)

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