Fat transfer to cheeks and lower eyes. Is this swelling and will go away or it is the fat and will remain like this? (photo)

Thanks for your question! Looking at your photos, it is extremely evident that you are very early in your recovery. Give your bruising and swelling time to come down. You won't see a final result for 3-6 months post-op with this kind of procedure. Continue to follow your doctor's instructions and be patient. Good luck!

It is possible to still be swollen 4 weeks after fat transfer.  However, the tear troughs are not an area into which much fat is injected.   Fat transfer to the tear troughs works very well if done correctly as this is an extremely vascular area.  It should not be overfilled, and only a small amount injected.  You may always need additional fat grafting, but the amount that establishes a vascular supply will continue to live permanently. You will know how much of the fat will survive at about 6 weeks but it could take as long as 3 months. Hopefully, you have visited your plastic surgeon to assess for bruising or fluid collection.  He or she should be able to give you a better idea. Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

It's in my experience that of all the facial procedures that are commonly performed (fat grafting, facelift, blepharoplasty etc.), fat grafting swelling takes the longest to resolve. All of my patients who have lower eye fat grafting are advised to expect some significant swelling (and distortion) for two weeks before it starts to look even "normal" again.  Understand that the lower eye tissue is very sensitive to swelling (even from just sleeping and allergies for example) and placing the fat does create a good amount of trauma to the area.Thus the fact that you are still not looking even close to normal is to be expected. I think it is good advice to take photos of yourself twice a week to see how the swelling is resolving.  If you take them every day (and compare day to day) you may not notice significant improvements.Obviously you should bring all of your concerns to your plastic surgeon and be sure they clarify what the expectations for healing are currently, but also for the next few weeks and months.Best,Doc L