Can filler be injected in lower leg after experiencing fat necrosis after an injury?

Question

Hi, I banged my leg and now there is a slight indent in my leg and im looking to get either filler or fat grafting done. I scar very easily and am worried about fat grafting due to the larger cannula. Can fat grafting be done with a very tiny cannula similar to a typical injection needle? Also is filller a viable option for lower leg? If the fat graft is the only solution can it be done near my ankle as the entry point for the indent in my lower leg?

Nelson Lee Novick, MD · Answer

A close-up photo would have been extremely helpful. I have personally been performing Subcision for over thirty years for naturally elevating & smoothing Indented scars from all causes, whether resulting from injury, infection, surgery, or acne. Since this is an entirely natural process, which depends upon the body's own healing to mechanisms to achieve results, this, generally speaking, would be a very logical treatment approach. If filler were to be considered additionally, I would personally be more inclined to use a natural HA filler, since, unlike using fat, this would not require a second surgical procedure to harvest the fat and large bore cannulas to inject it. You would be wise to make certain to consult with an experienced, board certified cosmetic dermatologist scar treatment and filler injection expert, and best of luck.

Anna Chacon, MD, FAAD · Answer

A dent in the lower leg after an injury can be frustrating, especially if it leaves a visible contour change. Both fat grafting and certain fillers may be options in selected cases, but the most important first step is determining whether the indentation is truly due to fat necrosis or whether there is associated scarring, tissue tethering, or another underlying change.

Dermal filler may be possible, but the lower leg is not a straightforward area to treat. The skin and soft tissue can be relatively thin, and fillers may carry risks such as unevenness, persistent swelling, infection, or vascular complications. There is also less evidence supporting filler use for traumatic depressions in the lower leg than for more commonly treated areas. The specific filler, injection depth, and location all matter.

Fat grafting is another option because it uses your own fat to restore lost volume. However, it is a surgical procedure, and some of the transferred fat may not survive, meaning the indentation could partially return or require additional treatment. A smaller cannula may sometimes be used, but fat grafting generally requires equipment capable of harvesting and transferring fat; it cannot usually be performed with an ordinary injection needle alone. Using a smaller instrument does not eliminate the risks of scarring or other complications.

Regarding your concern about scarring, a surgeon may be able to place an entry incision away from the indentation, potentially closer to the ankle, depending on the anatomy and the area being treated. However, this is not always feasible or advisable. The entry point must allow safe access and appropriate placement of the fat, and the ankle itself has important structures that must be protected.

My recommendation would be to have the area assessed by a dermatologist or plastic surgeon experienced in post-traumatic soft-tissue defects before choosing either procedure. If the injury is recent or the area remains painful, swollen, warm, or otherwise changing, the underlying tissue should be evaluated before any cosmetic correction is considered.

The goal is not simply to fill the dent, but to understand the condition of the tissue and choose an approach that provides the best possible contour while minimizing additional scarring and complications.

Can filler be injected in lower leg after experiencing fat necrosis after an injury?

Answers (2)

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