Facial Fat Transfer 1 year post-op, very bad swelling with lumps under my eyes. What to do? (photo)

In same cases fat tissue that does not get sufficient blood supply will die and turn into a scar or oily cyst. Additional inflammation would make that area to swell and enlarge; this may be what is happening in your case? Injection of Kenalog would calm inflammation and reduce swelling to a certain degree and possibly melt a portion of scar. Repeated injections are sometimes needed (2-3) to achieve maximum improvement. Residual lump may sometimes need additional treatment like liposuction with small cannula, direct excision or a combination of these. You should continue visits with your surgeon and follow his recommendations. Good luck.

I’m sorry you’re dealing with this – I know how frustrating it can be, especially when the issue comes back.
What you’re describing could be fat necrosis (hardening of fat) or scar tissue from the fat transfer. Sometimes, the transferred fat can clump or form nodules over time. The Kenalog (steroid) injection can reduce inflammation and swelling, but if the lump returned, it might need a different approach.
Options to consider: • Another steroid injection – Sometimes it takes a few rounds to fully resolve the swelling. • Dissolving or removing the fat – In some cases, small amounts of fat can be dissolved or carefully removed through a minor procedure. • Non-surgical treatments – Ultrasound or radiofrequency treatments can help soften and break down lumps.
I’d recommend following up with your surgeon or getting a second opinion from someone experienced in under-eye fat transfers.