Revision for Fat Grafting to Face
Sorry to hear you are going through this. While physical exam is crucial, I recommend allowing swelling to subside from recent liposuction, then repeat micro-liposuction in those areas of your face where fat persists. Steroid injections should only be considered for small, well defined areas of fat necrosis. If your surgeon is not boarded, get a second opinion from a board certified plastic surgeon. Good Luck!
Fat grafting in the lower face should be deep into the natural fat compartments, otherwise the fat will migrate down and that is the reason for the jowls.
Wait till all the swelling is down and if the jowls persist then liposuction of the jowls, and hope that the skin will retract, if the skin does not then a facelift is needed.
I would not use steroids to dissolve fat in the face because it does not act uniformly.
Choose an experienced Board Certified Plastic Surgeon. American Board of Plastic Surgery who understands the different fat compartments.
What you should do about your facial fat transfer problems.
transfer to the face is the most difficult transfer to accomplish because you
must consider the entire face and skeletal structure, replace lost volume from
aging and other causes, and create a more youthful and aesthetically pleasing
result. The short answer is to find someone who has performed fat
transfer for many many years and whose facial fat transfer photos you find
pleasing even talk to some of their patients. Correctly performed
FFT can create a thinner looking face even though you place more fat. For
example, I place up to 7cc of fat near the ear lobule and another 4-7 cc along
the jawline typically. I can put in from 30 to 60 ccs of fat in my facial
fat transfers, realizing that only about half will remain permanently, taking 1
½ to 2 ½ hours. This, along with the malar prominence fat transfer creates a
cheek hollow, and a more defined jawline that doesn't blend to the neck.
I would use suctioning only as a last resort to poorly placed fat transfer, and
accurately placed additional fat may be a better option. Use steroids
only as a last result, because they can cause skin thinning, Kelalog® is white
and it can show through the skin and facial skin is more translucent than
appreciated, and it is difficult to deliver accurately and diffusely. I
have only resorted to this a few time in my 25 years of fat transfer to the
face. I have used it for over abundant healing and scarring in the cheek
hollow with good results.
Fat transfer to the face is not just about the techniques of placing fat, but
knowing the three-dimensional geometry of the correct aesthetics of the face,
so it is also about the artistic eye of the doctor.