Asymmetry from fat grafting under my eyes. What options do I have for revision of this adverse result?

Question

As part of a face lift in January, my plastic surgeon used fat grafting in my lower face and along my cheek bones. I am left with extreme asymmetry in my lower face and an unnatural, over done appearence of my cheek bones.

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos, and I am sorry you did not see a satisfactory result from your facelift. Fat grafting is commonly performed with this procedure to volume in key areas and achieve the most natural facial contour. The problem with fat is that it requires a great deal of expertise and precision to perform correctly and even then, the results can be somewhat unpredictable. If fat is the issue in your lower jawline, there are ways to remove the fat and create a more symmetrical contour. I recommend scheduling a follow-up with your surgeon for a full assessment and discussion of your treatment options to correct this issue.

Anil R. Shah, MD · Answer

Asymmetry from fat grafting can be concerning to patients. There are a variety of techniques to correct this including addition (additional fat grafting and/or filler) and subtraction (kybella, lipocontour, direct removal).  Seek advice from a facial expert.  Best Dr. Anil Shah

Jag Chana, MD, FRCS(Plast) · Answer

It is a little difficult to assess this from the photographs provided. It would be useful to have better close up photographs. There looks to be some excess fat on the lower eyelids that should be amenable to correction. Usually fat is injected in the tear trough area at the lid-cheek junction with sometimes additional fat into the midcheek below. However, if there is persistent fat herniation which corresponds to true orbital fat this could be corrected. I would recommend you return to your surgeon for a further discussion

Andres Bustillo, MD, FACS · Answer

I would be ideal to have the  proper before and after pictures taken before your surgery to compare. I would suggest that you speak with your surgeon, review pictures and discuss a solution to your problem.

Michael P. Morrissette, DDS, FACS · Answer

You mentioned that you had facial fat grafting to your cheeks and lower face. The photos that you have provided show the typical pattern of orbital fat herniation that is seen when a patient is seen for a lower blepharoplasty consultation. I would recommend that you follow up with your surgeon to discuss whether this is the case.

Asymmetry from fat grafting under my eyes. What options do I have for revision of this adverse result?

Answers (10)