Kenalog injections for fat dissolving 1.5 years after fat grafting - how long will my results last? What are the risks?

Question

had cheeks fat grafting around 1.5 ago. fat took really well. got overfilled. another dr suggested steroid. kenalog injections. syringe 1.5. would that really help to dissovle extra fat? how long do these injections last? ive heard it could last up to 6 month long. would still work. what are the risks? never heard of kenalog in the context of fat dissolving. just inflamation dissolving. could it cause potential facial hair growth?

Mats Hagstrom, MD (license on probation) · Answer

Anti-inflammatory steroid injections have a number of potential side effects. One of these is fat atrophy.
It’s relatively rare in one study the incidence was reported as occurring in about one out of 200 patients.
It’s highly unpredictable and who gets the effect and how much atrophy occurs.
Generally when steroids induce fat atrophy the effect is disfiguring and causes problems.
For those individuals that get fat atrophy the outcome is usually devastating.
Steroid injections is a very ineffective and very imprecise way of trying to reduce poorly done facial fat transfer.
Out of 200 people treated 199 will have no such effect. The one that does would lose so much fat that they would look like they’re a cancer victim.
Steroids are not a fat reducing medication.
It’s a rare devastating side effect that happens occasionally.
You don’t want steroid induced fat atrophy.
It can melt the fat in your entire face.
The process continues for months after the injection and there’s very little anyone can do to reverse it once it stops.
Providers who do fat transfer should be ready to remove any fat grafted.
That is simply taking responsibility for operations you do and knowing how to manage undesirable outcomes.
Surgeons who cannot take care of complications from their own procedures including undesirable outcomes should not be doing the operations.
To reduce facial fat transfer liposuction or direct surgical excision are the two standard options.
Most likely your steroid injections will do nothing but I suggest you read up all the different side effects and complications related to steroid injections before choosing this procedure since it does not have a solid track record and it’s not considered standard of care for your condition.
Providers who recommend this are typically not sufficiently educated on steroid induced fat atrophy as a relatively rare event that causes destructive fat loss.
I am a 59-year-old board-certified plastic surgeon. This is just my opinion from my experience. I’m no expert but I’ve seen what I’ve seen and I know what I know.
If your provider has a proven track record with the procedure and can show you numerous quality before and after pictures and perhaps they know something I don’t.
I think I would want to see at least five or 10 sets of before and after pictures of quality outcomes before I would consider it something that is basically experimental and can potentially cause devastating outcomes.
Just my opinion. Take that with a grain of salt.
Best,
Mats Hagstrom MD

Kenalog injections for fat dissolving 1.5 years after fat grafting - how long will my results last? What are the risks?

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Kenalog injections for fat dissolving 1.5 years after fat grafting - how long will my results last? What are the risks?

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