I want fat transfer to the forehead to have a rounder appearing forehead, mine is flat and masculine. What are the risks?

Question

How do I avoid the risk of going blind or embolism?! If the doctor does it right, can I avoid this risk?

Afshin Farzadmehr, MD · Answer

It would be best to evaluate you for an assessment for suitability for such procedure and make sure you are a proper candidate in all aspects.  Thanks

Jason Emer, MD · Answer

This can be very successful if done properly.  To be honest however, I used to do this a lot but as the synthetic fillers have gotten better and are lasting longer I have found myself injecting these more often in this area.  I do daily injections on the forehead of bellafill, juvederm, and belotero.  They do very well to sculpt the forehead and make it more masculine and less aged. I suggest seeing only a well trained physician.  Using cannulas helps limit complications but often is difficult for this and you may need direct needle injection with precision.  Best, Dr. Emer.

Barry L. Eppley, MD, DMD · Answer

The biggest risk of fat grafting to the forehead, besides incomplete take of the graft, is lumpiness and irregularities. While fat grafting has many benefits for different facial areas of enhancement, the forehead is a large surface area and it is very difficult to get a substantial forehead augmentation with a perfectly smooth result.

John A. Millard, MD, FACS · Answer

As with any procedure, fat grafting is a surgical procedure, and it does have some risks.  These can be minimized with proper technique and expertise.  In the forehead, there is the inherent risk of not having all or any of the fat actually take.  Infections are pretty rare.  This are does have the added risk of blindness, because vessels in this area connect up with vessels in the eye.  One way I've been working to decrease this risk is with what is called UIGFAT (Ultrasound-Image Guided Fat Augmentation Technique_ where a surgeon uses ultrasound (Like what is used to see fetuses during pregnancy) and special needle cannulas that light up better under ultrasound.  Seeking a plastic surgeon who has lots of experience in the area of fat transfer in the face is your best bet!

Harry V. Wright, MD · Answer

Bleeding, infection, soreness and swelling are possible. The most significant risk is that your face may simply reabsorb all or most of the transferred fat. The chances of this happening can't be predicted for a given individual but is likely related of the mobility of the surrounding tissue. In my practice I minimize this risk by using Botox to temporarily relax the forehead muscles so that their movement doesn't interfere with the fat establishing a blood supply. Rare risks and complications include allergic reactions, discoloration, overcorrection, scarring, and embolism caused by a fat injected into a blood vessel (which can cause blindness). Proper technique and specialized injection cannulas that minimize the likelihood of entering a blood vessel are used to minimize this last risk. You can minimize all of these risks by finding an injector who has experience in fat transfer.Best wishes!  Harry V. Wright MD

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for your question and risks are minimal and embolism extremely rare so go on some consults and see what can be doneDr Corbin

William J. Seare, MD (retired) · Answer

I am one of the first pioneers in fat transfer and have been performing the procedure since 1988. I posted my  article to the Lipoplasty Society in 1989 about fat transfer and also wrote the first article about fat transfer survival rate  indicating a 50 percent survival rate using laser volume metric analysis. I believe your number one risk would be unevenness in trying to create an expansive convex arc along the entire forehead. I routinely fill in the temporal hollows on the side beyond the forehead to take away the skeletal look that sometimes happens with aging. Filling a hollow is much easier than expanding an arc. because of the demanding nature of such an undertaking, choosing a surgeon  with experience in and routinely performs fat transfer is mandatory and would be more likely to give you your desired result. I personally don't think Botox  would change the outcome  of fat transfer to the forehead. Due to the many factors that influence fat transfer survival to the location it is placed, it would be highly likely that you would need a secondary procedure to obtain the result you desire. Fat transfer has the best cost to volume benefit and as in the previous answer forehead movement could potentially effect short term and long term survival and evenness in forehead area.

I want fat transfer to the forehead to have a rounder appearing forehead, mine is flat and masculine. What are the risks?

Answers (7)

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