Fat graft removal/reversal - distinguishing between graft and natural fat

I have not had to remove any of my own fat grafts but I have removed fat grafts placed by other surgeons. Removing grafted fat can be challenging. However, typically the grafted fat is surrounded by scar tissue unlike normal fat. Ultimately the surgeon must use their judgement about how much fat to remove to correct the overfilled problem while not creating a new problem (hollowness). I always filter my fat down to fine particles to prevent lumpiness and problems down the road.

The problem with facial fat transfer is that the procedure is inherit, unpredictable, imprecise, and unforgiving if patients don’t like the outcome.It’s very difficult to remove previously grafted fat, and there’s no way a surgeon can differentiate between removing native fat and grafted fat.Sometimes the fat is not grafted in the subcutaneous fat layer, and this makes removing the fat that was grafted even more difficult.Sometimes removing previously grafted fat simply isn’t possible.I generally recommend patients use fillers because fillers are predictable, precise, and pretty forgiving if you don’t like the outcome.When it comes to having facial fat transfer, I recommend a conservative approach with an intention of grafting, more fat later if needed.The difficulty in removing previously grafted fat in the face is one of the big drawbacks of this procedure.Best,Mats Hagstrom MD