Can I Reverse Fat Grafting to my Cheeks After 6 Years? What about ATX-101?

I had fat grafting to my cheeks 6 years ago, and the results were permanent. Not much disappeared. I had more fat grafted around my cheeks to change the proportions, but that just made my face looked fatter. I then had some fat removed with microlipo, but not enough. The fat is so much a part of my facial structure now. I've got the bigsculpted cheeks whereas before my face was small and angular. Very different from how I used to look, and I never got used to it. What about ATX-101?

Doctor Answers 12

How to reverse fat grafting

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Over the last decade fat grafting has become a much more popular procedure. In the right hands it can be an excellent way to add volume to the face or other parts of the body. Unfortunately the survival of the fat is variable and in your case it sounds like too much survived (rarely the problem). Micro lipo with a very small cannula is probably the most precise method for fat removal. Any injectable agent is going to have a variable result and ATX-101 is not yet FDA approved. I recommend that you try the lipo procedure again. 


Daniel Medalie MD

Reversing Fat Transfer

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This is a good question.  

Fat transfer can be reversed in the right surgeon's hands.  This is a complicated subject due to the nature of the procedure.  Many surgeons feel the need to over inject fat to get a better result.  In doing so, the areas tend to look over filled and distort the face. The injected fat lives and becomes an integral part of the facial structure.  When this occurs, the patient usually feels his/her face is too heavy or too full.  This can be reversed in most cases. 

Each case is individualized and discussed in detail.  I utilize two different approaches.  The 1st is a conservative approach with micro-liposuction.  This is a procedure performed under local anesthesia with minimal downtime.  This gives an improvement and the goal is to restore facial symmetry.  The fat is removed and swelling resolves rather quickly.  The second approach is a surgical approach.  The surgical approach is via a face lift incision which allows access to the injected fat.  The fat can be visualized in this approach and removed directly.  This is a preferred approach in some cases due to the nature of the transfer.

I have utilized both approaches for removal successfully for great results.  The goal is to restore symmetry and facial features.

Kybella is the new Non Surgical removal of Fat and this is being used as well.  It is not exact and is a blind injection into the area.  It can be successful but will take several treatments.  I do not recommend this approach because it is not exact.  I hope this helps.  Good Luck

Kybella for the cheeks?

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This is an interesting question.  Currently Kybella is only FDA approved for submental fat deposits.  One of the risks with injecting Kybella is the products ability to potentially damage other structures (like nerves) that are close to where the product is injected.  In the meantime, I would recommend another round of microliposuction to help address the problem you describe.  Best of luck!

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Kybella to Dissolve Fat

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Kybella is a great product to dissolve fat.  However, it is currently only FDA approved for dissolving submental fat and not yet approved for other areas of the face or body. Best, Dr. Green

Kybella for cheek fat reduction

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There are some ways to reduce fat in your cheek and sculpt the face to make it appear smaller.  Kybella is only approved for reducing fat under your chin.  There are no studies that have evaluted the safety and effects of Kybella for cheek fat removal, therefore, I do not recommend using Kybella in this manner.

Liposuction vs Kybella

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Thank you for your question.  I would recommend that you visit with a plastic surgeon who can discuss you whether liposuction of the cheeks would be an option versus filling around the cheeks to allow for a more balanced volume distribution in the face.  I would not recommend Kybella at this time given the vital structures in the cheek that can be affected.

Kybella is not a good idea for cheeks

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I am sorry to hear that you are unhappy with your fat grafting results. Unfortunately, Kybella would not be a good idea in the cheeks for two reasons: first, it may damage your facial nerve, which would affect the movements of your face and second, it may remove too much fat from your cheeks giving you the opposite problem from what you are dealing with now. Microliposuction is the most precise way to address this issue. Best of luck!

Meghan Nadeau, MD
Seattle Plastic Surgeon

ATX-101 and Fat Grafting

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Dear pinkwoo,

ATX-101 or Kybella addresses the submental fullness, which is sometimes referred to as "double chin," in one 15- to 20-minute in-office treatment session. Kybella is the first and only FDA-approved nonsurgical treatment that contours and improves the appearance of your face by destroying the fat cells that sit beneath your chin. I suggest consulting with a board certified facial plastic surgeon to receive the highest quality knowledge, care, treatment and results.

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 123 reviews

Kyballa Post Fat Transfer

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This maybe a potential use for this medication in the future.  For now it is FDA approved for the submental area and the safety hasnt been evaluated for use in other areas.  I use 5fu/steroid injections to reverse any fat transfer irregularities or issues.  Fractional or deep RF help to smoothen out tissue as well.  I suggest seeing a cosmetic dermatologist with experience in body shaping and fat transfer. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 202 reviews

Uses for Kybella

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I am at the American Society of Aesthetic Plastic Surgeons meeting in Montreal right now and just had a long discussion with the Kybella people. They will reveal the costs in 2 months but it will be comparable to the cost of chin liposuction. They do not have FDA approval or studies for use anywhere else on the face. It will be widely available in July or August. Can't wait!

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.