I've developed two bags under my eyes after fat transfer. They look exactly like festoons. Is this normal?

Question

I am 4 weeks post-facelift with fat transfer under the eyes in the area between where under-eye skin meets upper-cheek skin (malar area?) The swelling, for the most part, has gone away. Now, however, I've developed two "bags" under my eyes. They are very soft and tender, and look exactly like festoons. Is this normal? Can I ask my doctor to do anything to reduce the puffiness (e.g, micro-lipo, steroid injection)? Thanks for your advice.

Manish H. Shah, MD, FACS · Answer

Hello chessmom,Thanks for your question.  A facelift with mid face fat transfer can temporarily disrupt the lymphatic drainage in the area around the cheeks.  This may be what you are seeing.  As such, time for the lymphatics to return to normal is essential.  I recommend discussing your concerns with your surgeon, but feel that a minimum of 2-3 months is necessary before you can really seen what is surgical outcome vs. post-surgical swelling.  Just be patient.Good luck,Dr. Shah

Greg Chernoff, MD · Answer

Thank you for your question. The healing time can be frustrating for a patient. You are 4 weeks into a one year healing time. There can also be good days and bad days with fluctuation in swelling. Continue communicating your concerns with your surgeon. He/She wants you to have a great result as well.

Robert M. Lowen, MD · Answer

What is described sounds like an undesirable deposit of fat, since most of the swelling is gone. You should have this evaluated by your plastic surgeon. One of the risks of fat transfer is putting too much fat in one place and getting a lump. The area described is soft, but tender at four weeks. The tenderness may be related still to the surgery. One would want to wait about three months to re-evaluate, if possible.  Most non-viable fat will go away by that time and you and your doctor can see if these soft, tender bags are going to persist.  If it turns out they do persist and are areas of over-fat grafting, further steps may be needed to remove them.

Vincent N. Zubowicz, MD · Answer

Swelling in the festive region can complicate the aesthetic convalescence from a facelift. Steroids are rarely indicated and it must be remembered that they can have negative consequences as well. As long as the trend is favorable I would leave the healing process alone.

Michael Kulick, MD, DDS · Answer

WAIT ! After 4 weeks, there will be a lot of changes in your facial appearance.  Stay in close touch with your doctor.  Intervention early on may make things worse.

I've developed two bags under my eyes after fat transfer. They look exactly like festoons. Is this normal?

Answers (8)

Answer: Most swelling should be left alone without invasive treatment

Answer: Most swelling should be left alone without invasive treatment

Answer: Two bags under my eyes after fat transfer and facelift

Answer: Two bags under my eyes after fat transfer and facelift

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I've developed two bags under my eyes after fat transfer. They look exactly like festoons. Is this normal?

Answers (8)

Answer: Most swelling should be left alone without invasive treatment

Answer: Most swelling should be left alone without invasive treatment

Answer: Two bags under my eyes after fat transfer and facelift

Answer: Two bags under my eyes after fat transfer and facelift

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Recommended reading

Everything you need to know about Facelift

Our mission is to create a world where every investment in modern beauty is Worth It.