HELP- botched fat transfer to bicep muscle looks deformed. Need it removed (Photo)

Question

Please read. I've been struggling with this for years and would do whatever it takes to have it properly resolved. A bicep fat transfer I had 10 yrs ago (21yo) has become too large, bulgy, uneven. friends & family ask me all the time why it's so big, if I do steroids (I never did steroids) & it really really bothers me. The issue is the FAT TRANSFER INTO THE MUSCLE. Primary (reputable nyc) plastic surgeon does not know how to solve this. Any ideas?? There must be a way to fix this in 2022

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. I think that at this point, the only reasonable remaining option is going to be direct surgical excision. Meaning open this area up with an incision and directly visualize and excise the area. Make sure you see a competent reconstructive surgeon in your area for a consultation.
Good luck!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

Daniel Barrett, MD · Answer

Dear Shabbyshane,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Miguel Mota, MD · Answer

Hello. This can be treated more or less like a lipoma removal. Lipomas are sometimes found inside the muscle. Lipomas have a capsule that allow for easier removal, nonetheless most of the fat can be removed in the same manner. Special care needs to be taken to separate the muscle fibers rather then cutting them, so there is slight risk of muscle deformity (it will look better then it does now though), but other then that it is pretty straight forward.

Best of luck,
Dr. Miguel Mota

Best of luck,
Dr. Miguel Mota

Connie Hiers, MD, FACS · Answer

Kybella injections, perhaps guided with ultrasound or other Xray, could be done to remove the excess fat. It will take more than one treatment and will need to be carefully done.

Douglas Taranow, DO, FACOS · Answer

If the fatty area is palpable, it should be able to be liposuctioned.  There is a good chance that there may be lumpiness or uneven areas after liposuction as the biceps muscle is in close proximity which accentuates the issues.
Dr. Taranow

Mats Hagstrom, MD (license on probation) · Answer

I continue to warn people about the impact of procedures that are permanent or semi permanent.
I encourage all patients to be very careful in selecting providers who have sufficient skill to deliver quality results.
With fat transfer especially in areas like the face I steer people away because it is very difficult to remove fat ones grafted. I see two approaches to reducing the fat in your arm. One is simply going in and doing Liposuction through the superficial part of the bicep muscle. The muscle will get beat up and have some injuries but the majority of fat is in the out side or superficial aspect of the muscle. The risks with any surgery and not all the fat will be gable to be removed but perhaps enough for it to be a possible decent outcome.
Alternative number two is to do an open excision and dissect out the fat.
That is probably safer but will leave you with a scar.
The problem with taking care of other doctors unhappy patients is that once you operate on them you know on the problem.
If things don’t turn out well patients don’t come back yelling at the original surgeon you were the ones who touch them last and you will hear the brunt of it. taking care of other doctors bad decisions or poor craftsmanship is fairly undesirable work. These patients are also apprehensive to have any surgical procedure because they have a sort of mild form of PTSD and are reluctant and on trusting of plastic surgeons. obviously everyone is different but typically the amount of Time spent consulting and managing follow up questions runs into hours quickly.
For that reason a substantial number of providers will just say no right off the bat. It isn’t worth the effort for them because they know the patient will never be happy and then they have to listen to the patient complain about all the problems.
Recognize this when you go in for a consultation. Taking care of other doctors unhappy patients is not what we enjoy doing though there are some who may be up for the challenge and in general people who go into medicine do so to help others know in plastic surgery it seems that greed appears highly motivating.
Continue having consultations until you find one who is highly experienced with both Liposuction and fat transfer. Bring with you copies of the radiographic images i’m assuming it’s an MRI. you should also bring with you proper before and after pictures and a copy of your original operative report if available. You should call your original surgeon to see if they still have those. You should also tell your surgeon that he or she is responsible for the outcome of your procedure and that includes doing the revision, that they should not have been grafting fat if they hadn’t thought through how to remove it later. you can tell them I said so.
Honestly this doesn’t look that difficult of a problem to deal with. Not all the fat needs to be removed just get your arm down to a size that looks close to normal.
Continue having in person consultations with local board-certified plastic surgeons in your community until you find someone willing to work with you seems to be talented and experienced enough to know what they’re doing.
No one is going to have a series of before and after pictures of reducing previously grafted bicep muscles. 
Instead ask them to review liposuction and fat transfer results and see what their portfolios look like.
For reference and experience surgeon should have hundreds of before and after pictures for commonly performed procedures.
If your original doctor is also in practice you may want to consider writing an honest review reflecting your experience with choosing that provider and the surgery they did.
When it comes to grafting fat it’s far better to graft conservatively with the understanding that you may need to do it twice into over graft and end up with some thing like what you have. I don’t know what your conversation was or if the provider showed you any before and after pictures before you decided to have the procedure. 
Can you call your surgeon reputable but let me tell you that reputable does not equal talented so perhaps you should let the world now with your views of the provider are.
Best,
Mats Hagstrom MD

HELP- botched fat transfer to bicep muscle looks deformed. Need it removed (Photo)

Answers (6)

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