Steroid to remove this localized facial fat transfer? (Photo)

Question

I had microlipo after fat transfer gone bad. Dr neglected the lateral cheek and I had localized fat probably a bit of fibrosis. Would steroid shots help bring it down?

Zoran Potparic, MD · Answer

Regardles of the technique and experience in fat transfer, lumps and irregularitiere are knownside effects! Dominant feature of fat grafts is their unpredictability; they may take better on one side or one location then other, in the same person, in the hands of same surgeon. Scarring due to fat necrosis (also side effect) may further affect result and cause asymmetry. Treatment of thise irregularities may be very difficult and involve multiple modalities. Starting with injjection of topical corticsteroid is a sound first step. Liposuction with a small canulla may be also considered. Hope this helps.

Mats Hagstrom, MD (license on probation) · Answer

Steroid injections are unlikely to improve your situation. Anti-inflammatory steroids have a rare side effect called fat atrophy. This is a rare complication that only happens in unusual circumstances. It cannot be predicted, and when it happens, it is usually devastating.
As a general statement, anti-inflammatory steroids, do not affect fat distribution. People sometimes believe that because it has a small incidence of a devastating, severe side effects called fat atrophy that it can be used in a purposeful way to reduce subcutaneous fat.
Because this is a rare side effect, it is unlikely to happen, and when it does, it usually dissolves all the fat in the area leaving people disfigured.
You do not want steroid induced fat atrophy in your face. Ever. 
Doctors continue to recommend and do this treatment with the belief that steroid injections can somehow reduce subcutaneous fat because fat atrophy is a rare side effects of the medication. Anyone who has had first-hand experience with steroid induced fat atrophy would have enough respect for the complication to not inject steroids, unless they were indicated.
This is only my opinion, and I’m sure there are other doctors who have different opinions and may have had different experiences than mine.
Generally speaking, I recommend patients avoid facial fat transfer, because the procedure is inherently, unpredictable, imprecise, and unforgiving. Your post is the exact reason why I try to steer people away from this procedure. We all recognize the desire to have permanent outcomes. Fillers are simply superior to fat transfer in every way. Fillers I like fat transfer are highly predictable , precise and forgiving if the results are different than what you had hoped for. 
Delivering consistent quality, fascial fat transfer results is also very difficult. The learning curve for this procedure is long and steep. Patients who do want facial fat transfer should recognize the inherit limitations and risks of the procedure, then spend a significant effort in finding the best and most experienced provider. I recommend patients do this they having multiple in person consultations. For most people seeking cosmetic surgery I recommend having five consultations to start with. For procedures that are complex with a high learning curve patients should consider scheduling more consultations to find the best provider. 
Follow up with your provider or schedule in person second opinion consultations with other providers.
Best,
Mats Hagstrom, MD

Steroid to remove this localized facial fat transfer? (Photo)

Answers (2)

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