I have too much fat in my face. Can it be improved?

Question

i had 4.5 c of fat added to each cheek a total of 9 cc after one year my face has changed shape and my cheeks look too big, also in different lights my cheeks look umungus and i have little slivers for eyes. what is the best way to remove fat without destroying my face or skin?? i was told hand held ultrasonic wands help in reducing the fat could this be true? thanks

Zoran Potparic, MD · Answer

That may be a significant problem considering that fat grafts are usually placed in multiple layers in the cheeks and around the eyes. Surgical removal is acceptable only for well defined lumps. However, if "swelling" is generalized, liposuction with small cannula and/or noninvasive management is indicated. We have no experience with kybella and could not recommend it. If you have gained some weight in the meantime, weight reduction may help.Good luck.

Mark Berkowitz, MD · Answer

Tellmewhy A complete consultation is necessary to determine your best course of action.  4.5 cc should not be an overwhelming amount as it is less than a teaspoon but if it has been a year and you are not happy, it does need to be addressed. I would discuss the following with your cosmetic surgeon:Steroid injectionsLiposuctionThermageVenus treatmentsExiliskybellaWhile this would be off label for many of these treatments you should be able to obtain the results you seek.  Best of Luck.

Jason Emer, MD · Answer

there are few treatments for this but some of those listed above have been used in my practice with success. I suggest seeing an expert, although often there is only improvement that can be obtained.  Best, Dr. Emer.

Michael M. Omidi, MD, FACS · Answer

I caution you on trying to remove the fat with any modality.  You may want to wait at least a year to ensure that you have your final results before making an assessment and decision.Removal of fat from the face is possible but it should be taken very seriously.  The fat is not in one pocket and is not easily removed by any modality. As you can imagine, any number of minor problems can making your results worse, not mentioning more serious problems. Give yourself some time to make the correct decision with a surgeon you trust.An in-person exam with a
board-certified plastic surgeon is the best way to assess your needs and
provide true medical advice.  Best of
luck. Dr. Michael Omidi

John A. Millard, MD, FACS · Answer

first of all, I suggest that if you are not at least 4-6months out from your surgery that you wait this long to judge what your results are.  As previously mentioned microcannula technique for minor adjustments of hat is helpful.  There are a few doctors using small fiber Smartlipo up around the orbital (Bone around the eye) area to remove fat.  Also surgical removal is a method.  It all depends in what layers the fat is and if that fat is easily accessible by the aforementioned told for removal.

Steven Wallach, MD · Answer

It can be very difficult to remove fat from the cheeks because fat injection goes in many layers and it is hard to liposuction. Ulthera may be helpful.

Cain R. Linville, MD, FACS · Answer

Wow this is sort of a new/tough problem seen more and more, since fat grafting to the face was so popular, or has become more popular over the last several years.  First, this technique should only be done if people's weight is very very stable.  If you gain weight, that grafted fat in your face still behaves as if it was in your abdomen.  Thus if you gain weight, that belly fat in your face will also gain weight, or increase in size.  There are a couple of potential off label ways to thin this problem down...  But the first option might be to do lipo.  Secondly, this was only mentioned while doing my Ultherapy training, but there is a thought that targeted ultrasonic energy delivery (i.e. Ultherapy), might help to dissolve this fat, although that's not been proven as far as I know.  So, the easiest way to remedy this, might be to get back to your previous weight if you've gained weight, as that fat will also shrink with weight loss.Second, only go to surgeons who understand this and are able to offer several options without being pushy.  Good luck!

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