Can Fat Injected at Temples Be Smoothed or Removed?

Question

Fat was injected into my temples to hide veins showing through my skin. The result is multiple, sizable lumps around my eyes. My doctor told me to stroke the lumps, but this has had no smoothing effect. It's been two years now . . . is there any way to smooth them to have them safely and successfully removed? They are hideous.

Michael A. Persky, MD · Answer

Aloha,

	Sorry to hear about your misfortune with fat grafting.  Unfortunately all the "stroking" in the world will not help the bumps two years after your procedure.  Fat that is present 6 months after fat transfer is yours for the rest of your life.  And by all means, do not gain excessive weight or that fat will really pop out.  It takes either surgical removal, microliposuction, micro-laser lypolysis, or added other filler to hide the bumps to correct your problem.  Good luck and be well.

	Dr. P

Jaime Perez, MD · Answer

Fat transfer or fat grafting is a common procedure performed by plastic surgeons and usually has a high patient-satisfaction rate.  However, reabsorption of some fat or hard lumps can sometimes happen, especially in areas where the overlying skin is very thin such (as the temporal area).  Initially, treatment consists of massaging the lumps, but if there is not improvement after two years, revision fat grafting will usually correct this problem.  Revision fat grafting consists of redistributing the fat with small cannulas, possible liposuction with very small cannulas, and repeat fat grafting to areas of concavity. 

	Jaime Perez M.D.

	Fat Transfer Specialist, Tampa, Florida 

	Plastic Surgery Center of Tampa

Thomas Fiala, MD, FACS, FRCSC · Answer

Hello - sorry to hear about your problem.

	There are a couple of choices that occur to me:

	1)  try to remove the fat, either through a direct incision (like a cyst removal), or thru liposuction

	2)  try to melt the fat - steroid injection

	3)  try to disguise the lump by layering other products nearby.

	 

	I'd start with #2.

	 

	Best wishes,

Ron Shelton, MD · Answer

If your lumps are large then possibly small cannula liposuction may help but it probably won't remove it all and you will still have some lumpy irregularity. Excision may leaves scars and indentations, not to mention considerable temporary bruising. Injecting corticosteroid may thin the fat but has a risk of over thinning and creating changes in the coloration of the skin. There may be no perfect solution to your problem, so it may be worthwhile not treating all of them until a test area is treated with whichever modality and await its result prior to deciding if all should be treated that way.

Toby Mayer, MD · Answer

These will need to be surgically removed by an experienced facelift surgeon. Usually these are surrounded with scar tissue and cannot be suctioned out,

Otto Joseph Placik, MD · Answer

Microcannula liposuction could perhaps be used to extract fat or at least cause significant distortion to soften the appearance of the lumps.

Michael Law, MD · Answer

I'm so sorry you experienced this. Fat grafting to the temples can provide a beautiful youthfu contour that can immediately make people look younger without drawing attention to the actual area that has been treated. Filling hollowed areas of the temples in a procedure that requires precision, expertise, attention to detail and specialized instrumentation.It is impportant not to "overcorrect: with fat in any of the area of the face, including the temples. But, there are options available and your situation can improve. The excess fat can be removed. Ideally, a copy of your medical records including your operative report could be available to the plastic surgeon making the correction so they know exactly what has been done.  I'm sure this is very very frustrating, but stay positive. Find a plastic surgeon with extensive with facial fat grafting and the correction and revision of fat grafting procedures.

D.J. Verret, MD · Answer

There are a couple of options to help with your problems:

	
		Microliposuction may be of benefit in the fat transfer areas.
	
		Additional fat injection to smooth the area.
	
		Steroid injection to cause atrophy of the fat.


	I would suggest talking with a facial plastic surgeon who has experience with fat injections to determine if these are applicable to your situation.

Philip Young, MD · Answer

You can smooth these fat collections in the temple with a number of different techniques. The options include steroid injections, mesotherapy, microliposuction, direct excision, more fat grafting to add around the lumps to camouflage the fat collections. Mesotherapy is a way of dissolving the fat with the use of certain agents. Steroids can be injected into the collection to dissolve it. Microliposuction is the use of cannulas to accurately suction the collection away. The last resort is to make an incision right above the collection and excising or taking the fat out directly.

Glenn Vallecillos, MD, FACS · Answer

Hello and thank you for the question.

	At two years, I am confident that massaging the lumps will not eradicate your problem. As some of my colleagues have mentioned, the treatment will entail surgical removal of the fat via micro-suction assisted lipoplasty. Additionally, you may require steroid injections as follow-up for any residual fat that isn't removed.

	Best, 

	Glenn Vallecillos, M.D., F.A.C.S.

Can Fat Injected at Temples Be Smoothed or Removed?

Answers (16)