Q: Dr. Eppley, I am interested in facial fat removal after fat grafting. Two months ago I had fat injected to my bottom cheeks (30 ccs of fat) and the result was horrible! Is there a way to remove this fat? Would be difficult to remove it all? Won’t be there any side effect resulting from the liposuction? And what about Lipodissolve (phosphatidylcholine), does it help melting out the fat? Would Lipodissolve eventually at the end of the required sessions would melt the unwanted fat? Unlikely liposuction, lipodissolve can be injected to muscles, right? Actually I am desparate and am going through a very difficult time because of my face and want to remove/melt as much of the injected fat as possible. How many sessions of Lipodissolve do you think I might need? And how long should I wait to get my old look back?
A: Thank you for your inquiry and sending your picture. Most likely some of the fat can be removed by small cannula liposuction. (microliposuction) It is important to realize that all of the fat may not be removeable. If some of the fat is on the muscle then that portion can not be removed. One must also be careful to refrain from too aggressive liposuction is this area to avoid injury to the buccal branches of the facial nerve.
The use of fat melting solution like phophatidylcholine (aka Liposdissolve injections) is that their effects are unpredictable and will require mutiple injections sessions to do so. For one week after each injection session the treated area will be swollen and double in size. There is no assurance that any chemical method can get rid of all of the fat. It is unpredictable. You never inject Lipodissolve solutions into muscle unless you want to potentially damage facial muscles as well.
It is also important to realize that the Lipodissolve solutions used in the past were made by compounding pharmacies and were not FDA-approved. The only true Lipodissolve solution that exists today is known as ATX-101 and is under clinical trials by the FDA and is not currently available for patients outside of the clinical trials. (it is only being tested for the reduction of submental neck fat) It will likely be fully approved for general patient use in later 2015 or early 2016. Thus there is little reason to continue the pursuit of Lipodissolve injectiojns as it is not available currently. (unless one wants to use unapproved solutions from compounding pharmacies)
Dr. Barry Eppley