Botched facial fat grafting, do not recognize myself - what should I do?

70 cc is not a lot of fat for the entire face. At 1 month or so you are still swollen. It is hard to tell what the issues are without photos. Much of the swelling can be reduced by reducing your salt intake and taking in more protein and sleeping with several pillows. This will likely go down significantly in the next couple of weeks.

Facial fat transfer is tricky business.

Grafting fat is finicky, and precise and somewhat of a clumsy procedure. that’s survival is unpredictable and it’s unpredictable in different parts of the face.

Plastic surgeons often of a graft to compensate for a significant percentage of fat loss overtime.

To avoid over grafting which can be a very difficult situation to deal with it’s generally better to graft conservatively and plan on doing several sessions and very gradually build up the volume.

70 mL is a pretty typical amount for full face grafting but there are a lot of variables such as if the fat was centrifuged and how it was grafted.

You should have no intervention within the first six months.

You need to let everything heal completely including allowing internal scar tissue to mature before considering another procedure.

As difficult as the situation is your owe it to yourself to slow down and not rush into procedures prematurely or before your body has healed completely.

At six months when the results are final and internal healing is complete then you can follow up with the surgeon who did the fat grafting and ask for his or her recommendations or schedule second opinion consultations with other plastic surgeons.

I continue to tell patients to be careful with facial fat grafting because it is fickle and unpredictable. The learning curve for this procedure it’s long and hard.

Patients need to be extremely cautious in provider selection. The importance of vetting plastic surgeons correctly cannot be overstated.

Generally this means having lots of in person consultations at which time I encourage patients to ask providers to show their entire collection of before and after pictures including excellent outcomes, average outcomes and poor outcomes.

An experienced provider should have no difficulty showing you 50 or more sets of before and after pictures. Highly experienced providers will have hundreds or possibly thousands.

Seeing a handful of selected pictures which in reality represent the best results of the providers career is insufficient to get a clear understanding of what average results look like.

Call it “bait and switch” or whatever you want it is standard in the industry.

Seeing select pictures and not being privy to the full collection of before and after pictures gives patient no idea of what one average results will look like for each provider.

Lastly I recommend reading all the reviews on various physician sites and avoiding providers with any significant number of justified negative reviews. The absence of justified negative reviews is more important and more telling than having out an abundance of positive reviews. Justified negative reviews are usually deserved and organic. The same cannot always be said for positive reviews.

At this point your job is to hurry up and wait.

Best,

Mats Hagstrom MD