What to do with overfilled facial fat transfer from a year ago? (Photo)

Thank you for your question and I’m sorry to hear about your less than ideal results. With any fat transfer, there is a likelihood of unevenness since the body does not retain all of the fat placed. In order to create a more symmetrical look, I would recommend Accutite and Morpheus8 combined therapies (called Embrace RF). The Accutite utilizes a small wand that heats and destroys fat from underneath the skin while the Morpheus8 applies radiofrequencies that improve skin texture and quality. By utilizing this dual approach, the excess fat can be targeted to balance out your features and provide more symmetry. Going forward, I would recommend you to schedule multiple consultations with board certified experts to discuss your aesthetic goals and craft your ideal treatment.

I would explore two options for overfilled facial fat transfer.  In areas that have lumps or are not smooth, one option is utilizing kenalog injections into the specific areas of concern.  This should be done with someone familiar with the use of kenalog and should not be overdone as this can in itself cause fat atrophy and skin changes.  You should go with a low dose of the steroid to see how your body reacts and repeat treatment if necessary.  Another option would to try Ulthera in the areas that are overfilled if it is a broad area.  Ulthera in some patients has the side effect of fat loss.  This would be more helpful in broad areas that need to be reduced.  However, not everyone who undergoes treatment with Ulthera has fat loss.  

Obviously staring people away from facial fat transfer or doing so with great caution and chosen only the best providers is a little late at this point. it is however an important point for others who are contemplating having facial fat transfer to consider. Lots of patients read these posts were considering surgery so I think it’s an important point to make.From your previous post you’ve already had one revision done in London. Why don’t you follow up with them since you were happy with the outcome.Treatment options are direct surgical excision of previously grafted fat. This is particularly useful for lumpy areas of fat necrosis. Other options include carefully done liposuction of your own virgin fat or the grafted fat. We can’t really differentiate which is your own native fat and which is the grafted fat when doing that procedure. Another option is to work with what you have, make an assessment and potentially add volume to under treated areas to create a better sense of balance. This can be done with the fillers or fat transfer. You already know about the pitfalls of fat transfer so it’s up to you if you would take the chance of having more fat added. That may or may not be an option in the first place.As is always the case your job is to find the best provider so start having in person consultations in your area.A simple post on real self is not going to get you a solid high-quality assessment. There’s too much limited information and we are really here to give simple answers.Your situation is complex and I don’t think simple answers are going to serve your needs at all.Get all of your previous surgical information together including all your before and after pictures then start making appointments with the best plastic surgeons in your area who have experience with facial fat transfer.In the end the best thing to do is to make an assessment which includes many different aspects including your facial skeletal structure, soft tissues age, skin, previous procedures etc. and then come up with a plan to help you look your best.Best, Mats Hagstrom MD