Can Fat Transfer Be Done in the Tear Trough, if Sculptra Was Injected Previously?

I had Scultra in the tear troughs 15 months ago with fantastic results. I then found RealSelf & read all the horror stories of latent granulomas requiring surgery that showed up sometimes months later. I am now weary of Sculptra. I am considering a fat graft for when Sculptra fades but am wondering if it can be done after Sculptra or if this might bring on the granulomas? Also what's up with patients growing visible veins in the under eyes after a fat graft & how can that be prevented?

Doctor Answers 7

Fat Grafting to Tear Trough after Sculptra

   Fat can be grafted to the tear trough after Sculptra has been injected.  It would be hard to predict relative risk of granuloma formation.  Kenneth Hughes, MD Los Angeles, CA

Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Fat transfer to tear trough

It should be safe to perform fat grafting to area of prior Sculptra injection, especially when it's over one year ago. Having said that, fat grafting to the tear trough is a procedure that requires very skillful placement of the graft. I suspect the veins were probably already present but become more visible after fat grafting.

Best Wishes,


Stewart Wang, MD, FACS
Los Angeles Plastic Surgeon
4.6 out of 5 stars 28 reviews

Fat grafting, Sculptra, tear trough

Good questions of which we do not have answers to all.

Sculptra can last up to two years.  If the effect has worn off and you have not had granulomas it would be difficult to imagine how fat would cause these to occur.

I am not aware of any research specifically studying this issue.

Granulomas are often caused by disparities in injection technique.  It appears that your injector may know the proper technique. 

Fat grafting not infrequently causes lumpiness in the tear trough.  Consultation and treatment by an experienced Board Certified Plastic Surgeon is recommended for this technique.  Cheers

Luis A. Cenedese, MD, FACS
New York Plastic Surgeon
4.5 out of 5 stars 19 reviews

Fat transfer for the eyes

Dear HappyGrrl,

  • It is best to wait for the Sculptra to resorb before adding fat to the area
  • I wouldn't worry about complications from Sculptra just yet because there is nothing to do about it right now
  • Establish a relationship with a plastic surgeon who does fat transfer in your area and you can follow your progress through standardized pictures

Best regards,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 74 reviews

Fat grafting after Sculptra

From what you are saying it appears that the sculptra is still present and hasn't resorbed completely.  Usually the granulomas will appear within the first year after injection.  Since you haven't had this occur, you are more than likely safe from this standpoint.  I would wait another few months before considering fat transfer, since the sculptra present now can alter the end result after the fat transfer is done.

Robert Kratschmer, MD
Houston Plastic Surgeon
4.5 out of 5 stars 36 reviews

Tear troughs not ideal area for Sculptra

It is more than likely that once you are ready for fat grafting, that the Sculptra would not be an issue, and granulomas likely would not occur. Fat grafting itself is a technique that should be used with great caution around the thin skin of the eyelids. Technique is very important, as is avoidance of overfilling in this area.

The photo you have provided is a bit distorted due to the lens, but I do notice lower eyelid retraction [the white of your eye is visible underneath the cornea].  This may be due to your head tilt during the photo...hard to tell.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 37 reviews

Fat grafting to tear trough after previous Sculptra

I've not heard of problems with having fat grafting placed in an area after previously having Sculptra injected. With proper techniques it is possible to avoid issues with lumpiness. The key is to place the fat in a deep enough plane under the skin and soft tissue.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 21 reviews

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.