Q: Dr. Eppley, I would like to know how long take scars go away from a fat transfer operation. They got some fat from my tummy and put under my eyes. I had a sleepy look eyes. It looks one side it’s kind of went down but my other eye (I mean under the eye) still all puffed out and doctor says its “scar”. It’s hard and it seems like slowly slowly is going away but I’m 10 months now after the surgery and still hard under the skin,
I would like to know if it will EVER go away that scar or will EVER become soft as the fat suppose to be? And if so WHEN? I’m really desperate. It’s my face and I don’t like that people looking at me like what happened to me. The idea was to look better not worse. :o((
A: Unfortunately you are asking a question about a clinical result that I have not yet seen with facial fat transfer. The biggest after surgery issues with injectable fat grafting is how well it survives and irregularities. (lumps/bumps) I have never seen persistent hard lumps many months after its placement. I would assume that it is fat and may or may not be some scare tissue. Certainly ten months is a long time but as long as there is some improvement in it, patience would still be warranted. I would also consider very dilute Kenalog (steroid) injections into to to encourage additional softening.
Dr. Barry Eppley
Q: I had my face injected with fat and it was initially overfilled. The doctor that did it said it would go down and look more normal but it has not. Can anything be done to make the fat go away or at least become less full?
A: Fat injections to the face is a good and safe technique for adding soft tissue volume to specific areas. Its almost sole problem is that its volume retention (aka how much survives) is not completely predictable. Studies have shown that certain areas of the face do retain transplanted fat better than others. For example, the cheek and side of the face do much better than that of the lips. Thus, it is standard practice to overfill or add more volume than one thinks is really necessary. How much one should overfill has never been precisely defined. Some plastic surgeons may do it just a little, others may significantly overfill.
Despite overfilling, the most persistent fat injection problem is that not enough ultimately remains. It is rare, but I have seen it, that too much fat remains. One should wait at least 3 months after facial fat injections to judge the outcome. By then, one is most likely looking at how much fat volume will be maintained.
There are two basic methods for reducing overfilled fat facial areas. If the location permits, ‘micro-liposuction’ can be done if a small incision can be cosmetically tolerated. The other approach is using injection therapy. I have seen successful use of either a steroid (Kenalog or triamcinolone) or very dilute Lipodissolve solutions. (phosphatidylcholine) The two can be combined together to create a mild fat dissolving solution that does not cause a lot of facial swelling afterwards. Injection therapy as the advantage of a non-surgical approach in which the treatment can be done in very discrete spots. It is also a more gradual process that lowers the risk of removing too much fat and causing the reverse contour problem.
Dr. Barry Eppley