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

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.

At 7 months, what fat is living will remain alive, but the fat that does not survive initially can still be palpable and visible as firm or irregular areas (scar fibrosis). As others have stated, fat grafts to the face can be unpredictable and not 100% of the transferred fat survives; thus, irregularities can indeed occur. Technique is critical for best "take" and results, but even with the best possible procedural details this kind of outcome can be seen in some cases.

At this point, very judicious steroid injection into firm raised or "lumpy" areas can help them soften and flatten, but where there is depression or indentation in the cheeks, further small-volume fat grafting (using low-vacuum syringe harvest and tunneling graft technique) can improve your results. I also assume you have undergone maximum external ultrasound and gentle massage treatments to soften the subcutaneous scar fibrosis (firm or lumpy areas) during the past few months. If not, this could provide additional subtle improvements, though I too feel you will need additional fat transfers for improved evenness. Best wishes! Dr. Tholen