I Developed a Lump in my Lower Eyelid a Few Hours After Fat Transfer. Will It Go Away, if Not, How Should It Be Treated? (photo)

I had revision Blepharoplasty yesterday. As part of the revision, a fat transfer was preformed. One eye turned out great while the other developed a lump and seems to still be a little hollow. I want to be educated on what this is and how it should be treated. Thank you!

Doctor Answers 2

Lower eyelid lump after fat transfer

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Fat transfer or grafting to the lower eyelid is a technically demanding procedure.  Fat is harvested in the form of tiny pieces and placed into the desired location very carefully using a blunt micro-needle to spread the fat pieces as evenly as possible.  This will ensure maximum survival of the transferred fat pieces so that they will become a living tissue again.  It is very effective in many parts of the body.  However the eyelid is unique in that it has very little fat between the very thin skin and the underlying sheet of muscle.  Therefore, fat grafting is done deep just above the bone and underneath the muscle layer.  It is possible to place it in the layer between the skin and muscle but has to be done extremely evenly.  Even then it should be done only in the lower half of the lower eyelid and never near the lashes.

At any rate, a lump is most likely due to an uneven deposit.  If it is recognized during operation, it can be aspirated using the same micro-needle that is being used to inject.  If recognized later, you might want to see what happens to the transferred fat before trying to remove it since not all of the fat in the lump may survive.  Fat cells that do not survive will be absorbed and disappear in time.  It may take many weeks however.  If it persists, again micro-suction would be the solution.  Certainly micro-suction is just as technically demanding as micro-injection in this area.

If it is just irregular swelling or bleeding (not likely without any bruises), it should settle within a couple of weeks from surgery.  

San Francisco Plastic Surgeon

Fat grafting to the lower eyelids

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One of the problems with fat grafting to the lower eyelids is that the skin is very thin and lumpiness can be a problem.  There is a good chance that the lumpiness will settle down on its own.  If it does not then you may need to have it removed.  It will take at least 6 weeks to know if  a revision is necessary.  

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.