Multiple Liposuctions or Steroid Injections to correct Facial Fat Transfer Overfill? (Photo)

5 1/2 months ago I was to have fat graft to correct hollows under my eyes and NL folds. When I woke he had injected fat to my cheeks, cheekbones and jawline. I now have a round face, undefined jawline, downturned lips, droopy cheeks and jowls. 14 days ago (5 mths after the FT), he liposuctioned my jawline and lower cheeks. My cheeks are thinner, but the jowls on the sides of my chin look worse. Can it be the LS swelling ? Should I have more LS or try steroids even 7 months after FT? Thanks in advance

Doctor Answers 4

Revision for Fat Grafting to Face

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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!

New York Plastic Surgeon
5.0 out of 5 stars 33 reviews

Fat Grafting

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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.

Samir Shureih, MD
Baltimore Plastic Surgeon

When you are in a hole, stop digging.

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Stop liposuction and steroid injections.  These will harm you.  I see 2 to 3 new patients a week who come to me for correction of complications from facial fat grafting.  Let the dust settle here.  I think your best bet is to find a cosmetic surgeon who can take a fresh look regarding what is going on here.  Hyaluronic acid filers can be profoundly helpful under these circumstances to help fill the face.  This can be done as a long term solution or at the very least give you some breathing room so you stop ping ponging from one bad service to another.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

What you should do about your facial fat transfer problems.

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Fat 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.

William J. Seare, MD
Carlsbad Plastic Surgeon
4.8 out of 5 stars 21 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.