Too Much Fat Injected During Transfer-looking Distorted and Freakish?

I had almost 80 cc's of fat injected during a facelift to cheeks, eyes, lower face, chin, lips and temples. Its approx 1 month out and it looks awful. All i keep hearing is it will get better and just give it time. Will one of you please tell the reality of how it will actually look? I was a very pretty woman before and now I look like a drag queen. I can barely leave the house and embarassed to be seen in public. I went to a top doc who keeps saying just give it more time. how can this be?

Doctor Answers 10

Fat Grafting - Too Much of a Good Thing?

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As with any cosmetic surgical procedure, there can certainly be 'too much of a good thing'. Over-grafting of fatty tissue will distort facial features and produce unnatural proportions that look like surgery rather than appearing to turn back the clock. An important part of my preoperative evaluation is reviewing photographs with patients from their twenties and thirties (and from their forties for patients in their sixties and seventies). Such photographs are invaluable in confirming the manner in which a face has aged, and in planning a surgery that is designed to help a patient look more like their youthful self.

Having said that, you are in the VERY early stages of recovery and it is very possible that when all is said and done you may be delighted with your results.  At this stage, sometimes significant changes can happenen even in 24 hours. Stay in close touch with your surgeon. he or she may have some additional suggestions that could be of benefit. Their guidance and understanding may also help you to feel more at ease. I wish you the best

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Too much fat grafted with face lift?

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I am sorry you are having an unhappy time with your face lift fat grafts.

My thoughts - 50 - 90% of injected fat will absorb. In the meantime,

  • You are very swollen both from the face lift and the fat grafts.
  • The swelling will subside and the fat grafts will absorb over 6-12 weeks.
  • 80 ccs is a lot - but some surgeons use a lot because so much absorbs.
  • See your surgeon to be sure there is no fat necrosis (hard, painful lumps) or liquefaction (liquid fat). These increase the swelling.
  • In 2 weeks, if still concerned your surgeon can do an ultrasound every few weeks see how fast the fat absorbs. Hope this helps!

Too much of a good thing?

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One month post-op is still early. Howevever,  too much fat transfer in one setting could results in fat necrosis and poor fat take. Too much of a good thing can lead to hard lumps and pumps.

Fat injection is a very refine and delicate procedure. The grafted fat survive by forming new blood supply to each individual fat cell. Therefore, the amount of fat being transfer in one setting is the key success.Over-grafting does not necessarily results in good result. It could lead to hard lumps and pumps and fat necrosis. Good luck.

Mytien Goldberg, MD, FACS
Los Angeles Plastic Surgeon

Too Much Fat Injected During Transfer-looking Distorted and Freakish

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Thank you for submitting your question and photo. It would be nice to see a before and after photos to compare.  The swelling can be asymmetrical and can last for several months. Final results take 6 months. Discuss your concerns with your Plastic Surgeon. Best wishes.

Too Much Fat Transfer During Facelift?

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As others have pointed out, at one month it is too early to judge if too much fat was transfered resulting in an unnatural appearance. For certain, you still have some swelling from the trauma of the procedure, and the fullness in the treated areas will definitely improve. In addition, the amount of fat survival is variable, but it does not all survive, so for this reason you should also see improvement. Both of these processes should result in a better overall appearance, so try not to be too frantic at this point. You do need to give it more time, at least 3 months, and possibly as much as 6 months, before you can judge the final outcome.

All that said, 80 cc's of fat is quite a bit in the face, even if you did have multiple areas treated. If the surgeon was overgrafting, anticipating that a significant percentage of the fat would not survive, then you may see quite a dramatic change. In general, I believe overgrafting is not a good practice, because it has unreliable results and can lead to things like oil cysts and fat necrosis. These problems can be managed but are annoying. Finally, if it appears that too much fat has been placed in certain areas, it can usually be improved by careful laser fat reduction. Some patience will be required before you can tell if any further treatment will be necessary. 






All that said, 

Fat transfer with a facelift

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Dear Blondie,

  • The combination of the 2 procedure definitely causes prolonged swelling
  • Also, the fat will resorb as it heals
  • I can feel how it is hard to wait, but please be more patient
  • Once the face stops changing (i.e. the swelling has stabilized), then you can assess what to do next

Best regards,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews

Most surgeons over correct with fat grafting anticipating only partial "take" of the fat.

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Making judgments about volume after facelift with concurrent fat injections is impossible at one month. The situation should improve substantially over the next few months as the swelling goes down and a portion of the fat graft that didn't survive is removed by the body.

Swelling and Distortion of Face One Month After Fat Transfer

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Hi Blondie,

Sorry to hear about your dilemma.  Prior to fat transfer, patients need to be informed of how they may appear very swollen for a few weeks after the treamtent.

The problem with fat transfer is that it can be unpredictable even the best surgeon's hands.  That is because the amount of fat that lives or takes varies anywhere from 40% to 60%.  What is predictable is that at 5 to 6 months after your fat transfer, the fat that is still present is your fat for life, permanently.  Often fat transfer surgeons over correct due to the reabsorption after treatment, resulting in distortion.  Hopefully over the next few months your fat will settle.

Though I occasionally still use fat transfer, I find that Sculptra is much more predictable and is less likely to cause the distortion that you are describing.  I hope that your face settles well over the next few months.

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Patience is key

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Honestly, until you are about 3 months out from surgery, you won't know your final results. The fat will continue to resorb in the next 2 months.

Only about half of the fat that is injected into the face survives, so we tend to need to over fill at the time of surgery in anticipation of this.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 41 reviews

Fat Grafting with 80 ccs to the Face

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    The fat grafting results at one month typically do reduce.  Usually by 3 months, the results are fairly stable.

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.