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

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?

Doctor Answers 20

Fat injections/ fat transfer

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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.

Uneven cheeks after fat transfer

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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.

Face lift fat grafts

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Thank you for your question about your fat grafts after your face lift.

  • Your post face lift photo suggests possible facial scarring, more fat survival than planned or irregular fat injection.
  • As your surgeon about your treatment options.
  • Very dilute steroid injections, re-draping skin, removing scar and/or fat or careful new fat transfers all might help.
  • Discuss this with your plastic surgeon and together make a plan to correct it.
  • Hope this helps!

There is the possibility that the irregularities are from the face lift part as well

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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

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Uneven Cheeks after fat transfer

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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.

Jonathan Berman, MD
Boca Raton Plastic Surgeon
4.7 out of 5 stars 19 reviews

Uneven Cheek following facelift.

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Thanks very much for your question.  It's difficult for me say for certain without seeing pre-operative photos.  However, it is common for only portions of the fat transfer to remain after the procedure.  If you have some unevenness speak with your doctor.  Some may go away on it's own but some may require a minor touch up procedure and only they would be able to give you accurate information since they know what was done during your procedure.

Shaun Parson, MD
Phoenix Plastic Surgeon
4.8 out of 5 stars 47 reviews

Irregularities after Facelift and Fat Transfer

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     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

Uneven after fat grafting

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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.

Cause of Uneven Cheeks after Fat Augmentation and Facelift

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If you did not have this asymmetry before surgery it is secondary to scarring after the facelift or uneven placement or survival of the fat. A minor revision of the facelift can be done. I have been doing fat transfers for over 25 years because I prefer using the patient's own tissue whenever possible.  Problems with fat or fillers are frequently technique dependent. If the fat is causing irregularities more can be injected to improve the contour.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Facelift and Fat Transfer

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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.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 103 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.