How to Reverse Fat Transfer Under Eyes?

Question

7 weeks ago I had fat transferred under my eyes in conjunction with a mid face lift. I didn't have bags before, but do now. My ps suggested this would be good along with the FL. I don't to make it worse but I look like a "before" now. Follow up appt with ps next week. Thank you.

Michael A. Persky, MD · Answer

Hi,

	Be patient for at least a few months.  It takes time for fat to settle and for the swelling from your surgery to resolve especially around your eyes.  After 5 to 6 months, the fat that is present will likely be permanent.  Follow your plastic surgeons advise.  Too many patients try to find a quick fix for this problem, find a physician willing to treat them for the right price, and a situation that may have resolved on its own turns into a most difficult to correct nightmare.  If you trusted your surgeon with your face for the mid face lift and fat transfer, trust her/him with your post-operative course.  Patience is its own reward. 

	Be well.

	Dr. P

Houtan Chaboki, MD · Answer

As plastic surgeons have already mentioned, time is a good option, especially this early after treatment. Fat injections have a certain degree of unpredictability of duration. Even though it's your own fat and a natural filler, a percentage of injected fat will dissolve slowly over time. Another alternative is into inject steroid to remove small nodules of fat. Lastly, fat may be physically removed with liposuction or further cosmetic surgery. Speak with your plastic surgeon to help determine appropriate options for you.

Otto Joseph Placik, MD · Answer

This is still early to make any surgical decisions. There are some non-surgical options such as scar massage and some surgeons would consider steroid injections but this is not without serious risks. Surgical options include liposuction and or fat extraction via incisions.

Ricardo L. Rodriguez, MD · Answer

This is not an uncommon problem.

	I think it is caused by injecting the fat directly into the hollow below the eyelids, sort of "lifting the line" as one would do with Restylane. 

	I inject the fat differently, addressing the whole area under the eyelid to get a more diffuse effect. 

	I have had the chance to reduce fat under the eyelids from several other surgeons, and it is done by liposuctioning the area with a very fine cannula that is otherwise used for infiltration. Success depends both on suctioning some of the fat,  but also on breaking up the fat and undermining the tissue. Thus you leave some of the fat to correct the original deficit.

	Check out the link below, they have all had fat under the eyelids.

Ron Shelton, MD · Answer

Your plastic surgeon will determine if this is swelling or fat. Some of the fat will continue to dissolve and you may need to be patient for several weeks before attempts are made to remove it.

Peter A. Aldea, MD · Answer

You appear to have diffuse swelling and prominence of the lower lids. Since all fat grafting is associated with significant swelling AND a significant portion of grafted fat does not persist it is too soon for you to panic. Before beginning to consider modalities to reverse fat grafting to the lower lids, none of which are easy nor predictable, I would allow the swelling to resolve and the grafts to settle. You may be pleasantly surprised.

Darryl J. Blinski, MD · Answer

Very early in the healing phase, WAIT! If after 2 months no improvement than intervention by either injections of a steroidal, phospholipids, hydraurondiase. Or a possible direct excision.

	From MIAMI Dr. B

How to Reverse Fat Transfer Under Eyes?

Answers (7)

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