Can I get a fat grafting revision? (Photo)

Question

Hello, I had poorly done fat grafting in my marionette lines 10 years ago. It was placed too superficially. It has always appeared as a small buldge. However, it was not extremely noticeable. Now that I recently had a mini facelift, the two lumps sit higher up. Because they are no longer in an area where there is a small depression and the skin is smooth around them, they buldge out of the skin more. Also, they are in a location that makes them look unnatural and strange. Options? Kenalog?

Gurkan Kayabasoglu, MD · Answer

Hello. You can get rid of the fullness in this area with a properly planned mid-face lift surgery. Mid-face lift, it is aimed to lift the part of face where the cheeks are formed. Generally, in younger patients, in cases where the jaw line is not too distorted, there is not too much sagging and fat in the neck, these are surgeries performed only to make the cheek pads and cheekbones more prominent.  Generally, an incision is not made on your face for the surgery, small incisions are made through your hair and through these incisions, deep tissues are suspended upwards by means of cameras. Thus, there is no scar after this surgery. I’m the only triple board-certified facial plastic surgeon all around Europe. I’m just focused on this issue. I am a doctor who goes to almost every country in the world and explains my techniques to important doctors with the congress invitations I receive, so I am definitely the only doctor who can perform your operation very comfortably and successfully. You can get more detailed information about me, ask all questions about your case and sending your photos to my assistants at the number on my profile (+90 539 204 40 90). You can also book an online consultation and discuss your problems with me. With all respect.

Mats Hagstrom, MD (license on probation) · Answer

Marionette lines do not respond to volume augmentation. Unlike nasiolabial lines that respond well to fillers marionette lines do not.
I generally steer people away from facial fat transfer because the procedure is inherently imprecise, unpredictable and unforgiving which you now are first-hand witness to.
Removing previously grafted fat is difficult and the only real options are attempted liposuction or direct surgical excision.
Liposuction cannot differentiate native fat versus grafted fat and the chance of the contour turning out the way it was before fat transfer or the way you want it to look is not guaranteed by just trying to do Liposuction. Open excision is probably unacceptable on this part of the face and excessive.
Your situation is complicated and there is no easy answer. Manipulating the contour by adding fillers to make the overall contour more smooth and even it’s probably your best bet. doing this well is something that is a bit of an art that some people do better than others.
Kenalog injections will not reduce fat. anti-inflammatory steroids can occasionally cause fat atrophy. it is not a normal response to steroid injections and when it happens it’s usually quite catastrophic. trying to induce steroid induced fat atrophy is most likely going to lead to an unnecessary steroid injection. The incidence of fat atrophy from stared injections as less than 1% and when it happens it typically is far greater than what patients had ever hoped for. steroid induced fat atrophy can be devastating.
Likewise injecting chemicals like Kybella (Deoxycholic acid )is more likely to give negative results then what the intention was.
Perhaps someone else will come up with a more brilliant solution. if you opt for any permanent option of treating this make sure you’re in the hands of someone who is skilled, experienced and has wise judgment.
Best,
Mats Hagstrom MD

Can I get a fat grafting revision? (Photo)

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Can I get a fat grafting revision? (Photo)

Answers (2)

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Everything you need to know about Facial Fat Transfer

Our mission is to create a world where every investment in modern beauty is Worth It.