Overfilled facial fat transfer 3 years ago - how can this be removed? (Photos)

Question

Im 34 and I got facial fat transfer 3 years ago during a revision rhinoplasty. My cheeks were definitely overfilled but I didn’t realize how bad it was until a few months ago when I posted my photo into an online advice forum and everyone and I mean everyone, commented on my cheeks and that I looked like i had a ton of Plastic surgery and destroyed my face. I desperately want it removed but i know since it’s fat, it’s going to be complicated and difficult. From what I’ve read liposuction and surgery are options but I don’t want to make things worse and I’m afraid I will, or that I’ll end up with lumps and scarring. I’m getting another revision rhinoplasty soon for a collapsed septum and I want to raise the issue with my doctor but he seems very nonchalant about the whole thing and doesn’t seem to indicate any concern or care. what should I do? I feel so much anxiety and I’m so unsure of how to proceed.

Julian De Silva, MD · Answer

Hi Michelle, thank you for sharing this, and please do not let strangers on a forum define how you feel about your face. From your description and photos, the good news is that grafted fat which has survived three years is stable tissue, and stable tissue can be assessed and treated predictably. Reduction is usually done with very fine micro-liposuction cannulas through tiny access points, working conservatively and sometimes in more than one stage, precisely to avoid the lumps and irregularity you are worried about. Removing a little less than you think you want is the safer path, because overcorrection in the midface is much harder to reverse than a modest touch-up. In some cases microdroplet steroid or enzyme-free contouring alternatives are considered, but fat responds best to careful mechanical reduction. Since you are already planning another revision rhinoplasty, it is worth having the cheeks examined in person at the same consultation, as facial proportions are judged together. Choose a surgeon who regularly performs revision work on fat grafting, ask how many of these they do, and no one should promise you a perfect result.

Overfilled facial fat transfer 3 years ago - how can this be removed? (Photos)

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