Filler for Atrophied Butt Caused Kenalog Injection?

Hello Dooby,  Corticosteroid injection, such as Kenolog, can result in atrophy of the subcutaneous fat of the injection site. The process results in fat necrosis and scarring. Keno log is a long acting steroid, so I generally recommend waiting for at least 6 months prior to performing any definitive treatment. Initially, conservative therapy, including message and ultrasound therapy, is advised to soften the scarring. I have treated several patients with similar dents. I generally do not recommend the temporary fillers due to the large volume required to correct these deformities. Fat transfer is ideal to correct this problem. Fat transfer can be performed in the office with local anesthesia to fill in the contour deformity. Most of the time only one treatment is required. If there is a large deformity, or excessive scar tissue, a second treatment may be required.

I would recommend consulting with a Board-Certified Plastic Surgeon.

Best regards, Andrew Lyos, MD, FACS

Hi Dooby,
I've taken care of a few patients who developed significant atrophy of the fatty tissues after corticosteroid injection. The first thing to realize is that atrophy of the fat is a process that evolves over several months. Before you seek any long-lasting treatment, the best thing to do is to wait for several months until you are sure the indentation isn't getting any worse or any better.
My best results have been achieved with autologous fat grafting. Because the goal of surgery is to replace missing fat, and fat is a semi-permanent filling material, it's always made the most sense to me for this particular indication. Some of the fat re-absorbs in the first few weeks to months after surgery, so a secondary touch-up procedure is sometimes required. All in all, though, the results are quite good.
Hope this helps. Best of luck.