I had fat transfer to my face, too much fat was put in and face is too round. Can it be removed? (Photo)

I had a fat transfer to my face and way to much fat was put in. I did this 8 months ago. I was filled with so much fat to the middle of my cheeks all the way down to my jaw line and chin area. I had a slim sculpted face before and now my face is very round and uneven. I lost my thin sculpted face. I'm 5'2 & 103 lbs & don't want to gain weight because my face is so fat and round from the fat transfer. Is there any plastic surgeon out there that can and will remove the fat that was put in my face?

Doctor Answers 4

Facial Fat Removal

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It is not as easy to remove fat from the face as it was to put it in. But small cannula liposuction may be able to remove some of the fat in select locations. The issue with  aggressive liposuction in the face is the risk of a temporary injury to branches of the facial nerve in the zone between the cheeks and the jawline. But when done carefully, improvement in facial shape can be obtained with a low risk of any nerve problems.  

Fat transfer to face

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I think that you need to give it a year for swelling to be completely gone. A careful evaluation of before and after views are helpful.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Too much fat after fat transfer

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To answer your question, yes, something can be done. Find a plastic surgeon with considerable experience and expertise with structural fat grafting, and with the correction of unfavorable fat grafting results. Removing overfilled areas of fat can be challenging, but it is possible.  In some areas, such as around the eye area, direct excision of excess fat through surgical incisions is often required.  In areas of greater soft tissue fullness, like the cheeks, fat can be aspirated (gently removed by suction using fat grafting cannulas of slightly larger diameter than those used for placement of fat) to reduce an 'overgrafted' appearance.

In years past, plastic surgery patients who looked "done" had that appearance because skin was pulled tight without adding soft tissue volume, and patients were left with hollowed-out and windswept-looking faces. Today, it seems that the increasing use of non-surgical temporary and semi-permanent fillers, and the permanent filler that is fat grafting, has produced a new kind of "done" appearance: the artificially overfilled face. 

If a physician is new to fat grafting, and especially if they are not confident about their instrumentation and technique, then they may tend to over-graft thinking that a large amount of the fat probably will not survive. However if a large amount of that grafted fat does survive, the patient is left with an unnatural and sometimes bizarre look. Another part of the problem can be the physician's aesthetic vision and understanding of facial aging. There are facial areas where adding volume restores a more youthful appearance, but others where adding volume creates a distinctly unnatural appearance.  Balance and overall facial harmony is important as well - for example, overfilling the jawline and lower face will create a heavy, square-jawed, masculine appearance. 

Additionally, there are facial areas where naturally-occurring fat, which increases in volume with advancing age, ideally should be removed: the area above the nasolabial folds, the area lateral to the corner of the mouth, and the jowl area. As I described above for removal of excess fat from a prior fat grafting procedure, excess naturally-occurring fat can also be removed by gentle aspiration (suction) using larger-diameter fat grafting cannulas. Failure to reduce these naturally full areas at the time of a fat grafting procedure can also contribute to an overly full or 'heavy' post-fat grafting appearance.

I try to create the greatest aesthetic improvement possible without creating an unnatural appearance. This concept is critical: the nature of fat grafting is that fat survival often is not 100%, and therefore some patients will require secondary fat grafting procedures to build on the results of the first one.  If a physician's approach to fat grafting respects this reality, then that practice will offer secondary fat grafting procedures at a very reasonable cost, which allows patients to achieve their desired endpoint in volume enhancement without appearing overgrafted and without assuming an excessive expense.

Fat grafting (and simultaneous strategic fat reduction) is very much like sculpting, and the sculpture is not always complete after the first session in the artist's studio. Secondary sessions, usually quite minor compared to the initial procedure, are sometimes required to perfect the result. In many cases, a series of two or three structural fat grafting / strategic fat aspiration procedures can simulate the results of a more invasive facelift-type procedure, particularly in the cheek and jawline area - as long as the overlying skin tone is good.

If a physician's approach to fat grafting is that the procedure is a 'one-shot deal' and 'you get what you get', then that practice does not respect the scientific basis of fat grafting and patients will tend to get disappointing and unnatural-appearing results.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Fat Transfered Is Hard to Remove

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Once fat is transferred it is difficult to remove.  There are surgical and liposuction options, but you should wait 6-12 months before considering this.  If you trust your surgeon, explain to him your concern and see if he has a reasonable treatment option for you.  Most people "over fill" during the treatment, because they feel some of the fat does not take during or shortly after transfer.  You may have been one of the lucky ones to have had a considerable amount of your transferred fat to take and remain.  I wish you the best of luck, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 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.