Undereye fat transfer: Is it better to undergo local liposuction or moderate kenalog injection to reduce unevenness in a fat transfer procedure?
Undereye Fat Transfer: Is It Better to Undergo Local Liposuction or Moderate Kenalog Injection to Reduce Uneven Fat Transfer?
Doctor Answers 2
Uneven fat transfer
It depends on how long ago you had the injection. In the initial 2-3 weeks it is not uncommon to have some asymetry but if its been months and you have a noticible difference under your eyes, there are several options. You can have additional soft tissue injected to the deficient side to achieve better symmetry. You can also try to reduce or remove the excess fat by steroid and/or 5-FU injections. Steroids can also cause subdermal lipoatrophy that can create skin dimpling. You can also have a localized subdermal laser lipolysis treatment with Smartlipo or similar commercial LASER. Lastly, you can have it surgically removed by localized liposuction or fat excision going through a blepheroplasty incision or gingivobuccal approach (through the junction of cheeck and gums). My preferance would be to start from the most conservative and least invasive option.
Correcting uneveness with fat transfer to tear trough
In cases like this, it is of course more helpful to see a photo; exam in person is key for appreciating the 3D contours. Nevertheless, it would be more reasonable to start with a dilute kenalog injection to correct nodularity after fat transfer. Risks include dermal depression and thinning if injected too superficially, as well as telangectasia (broken blood vessels visible on skin). If there is too much fat in an aesthetically unappealing area, then direct surgical excision is best, although a needle could be tried first with a syringe by hand, if that's what you mean by "local liposuction".