Why Do I Have Uneven Cheeks After Fat Transfers and Face Lift? (photo)

Question

I am 7 months post op. I do not have smooth cheeks after fat transfers to areas beside mouth and face lift. What is the cause of this and what can be done?

Alejandro J. Quiroz, MD · Answer

The unevenness in your face maybe, do to uneven placement of fat on your face. After 7 months, do not expect that the results would change to much, and as to the treatment new fat injections and probably some fat suction is recommened.

Kenneth Hughes, MD · Answer

It is difficult to make any suggestions from this one photo. If you posted photos of both sides of your face as well as preoperative photos more helpful suggestions could be made. Fat grafting to depressed areas is reasonable. Find a plastic surgeon with ELITE credentials who does hundreds of facelifts and fat transfers each year. Kenneth Hughes, MD Los Angeles, CA

Ronald Schuster, MD · Answer

Fat grafting is not an exact science and the final results depend on many variables, including the quality of the fat harvested, the technique used to process and transfer it, as well as the area it is being placed. Over time the results have improved but not perfected. The areas which are uneven I believe can be treated with either further grafting or off the shelf fillers. Discuss your concerns with your surgeon who I bet will want to help you, and probably give you the best deal. Good luck.

Stephen Prendiville, MD · Answer

As others have stated, the asymmetries are most likely related to the survival and lack thereof the fat grafts Although the technique has strong proponents, my preference is to use Sculptra in shaping facial volume in conjunction with a facelift. Sculptra offers gradual facial volume changes that is safe and predictable without need for a donor site. Both fat transfer and Sculptra require repeat procedures in order to accomplish the desired result.

Evan Ransom, MD, FACS · Answer

Thank you for this great question. Fat grafting can be a great treatment, particularly when it is paired with other techniques like a facelift. The reality is, however, that not all grafts will "take" (survive), and this can lead to some asymmetry in the result. An additional session of fat grafting, after an appropriate amount of time allowed for healing from your operation, will generally help. Having a open conversation with your surgeon is essential during this process. Best of luck!

Vincent N. Zubowicz, MD · Answer

Fat grafting has a degree of unpredictability. Asymmetries after grafting are not uncommon. Generally this is dealt with by re-grafting areas that are relatively deficient.

Romy Ahluwalia, MD · Answer

Micro fat grafting helps ensure a smooth contour md avoids any palpable fat necrosis. If you had micro fat grafting done, it’s possible you had variable resorption, in which case more can added to even it out. It’s hard to say from photographs alone

Remus Repta, MD · Answer

Hello Corbarlin,

	Thank you for the question and the photo.  The irregularities that you show can be from the face lift, the fat grafting, or both.  If the irregularities were there from either the beginning or soon thereafter I would suspect that they are a result of the face lift.  If they appeared much later in the recovery they can be from the fat grafting alone or in combination with the face lift.  What needs to be done depends on what improvements are intended.  If additional tightening or other face lift type procedures are needed a revision face lift will likely help correct the issues.

	All the best,

	Dr. Remus Repta

Jonathan Berman, MD · Answer

I ask my patients to wait 6 months before making a final determination, as autologous fat grafting does not survive 100%, and I generally slightly over-correct because of this. I feel that it takes approximately 6 months for everything to even-out and if, indeed, there are asymmetries, I can address them at that time.

Robert L. Kraft, MD, FACS · Answer

One of the downsides of fat transfer is that the fat may not be absorbed equally on both sides. We still know much too little about the mechanism of fat transfer. In this case, you may need a touchup on one side. Depending on your feelings about fat transfer at this point, you could either have additional transfers or try conventional fillers, such as Radiesse, to improve hte contouring.

Why Do I Have Uneven Cheeks After Fat Transfers and Face Lift? (photo)

Answers (20)

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