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Are there any risks or negative effects from fat injection?

Q:

I am scheduled for an under eye blepharoplasty, plus "Fat Augmentation". I have extra skin under my eyes plus puffiness. So as my surgeon explains it, he plans to reposition the fat under my eyes & add fat if needed to smooth everything out, including going under tear troughs & adding fat to lift them up a bit. He also plans to add some fat to my upper lid orbital area & temples to correct hollowness. Is this considered common? Any risks of negative effects?

A:

Liz,

 

 Photographs would have been of great assistance but, what a you are describing is the current state of the art of Occuloplastic & Facial Plastic Surgery. Surgery always has risks. May I suggest you address your concerns with your surgeon well before your scheduled date for surgery. Best,

 

Gary R Culbertson, MD, FACS

A:

Repositioning the fat and even adding some is now considered the standard of care in lower Blepharoplasty. If you have a temporal hollow, it makes sense to add fat there at the same time. While there are risks, they are minimal and generally that you may have to add some fat later if you do not get the correction you expect.

A:

Maintaining as much volume as possible or adding volume if possible gives youthful contours to the face and eye area.  Repositioning fat in the lower eyelids helps fill the hollows below the eyes and can work well.  Fat injections have received a great deal of media attention and hype and there is a great deal of research going on about how to make fat transfer work predictably.  However, it is well known that not all the fat survives, so it is unpredictable how much volume may be maintained.  This means you may require additional procedures to get to the endpoint you wish.

A:

Dear Liz,  We have learned so much in the last few years about how aging changes our facial anatomy and this knowledge is also changing how plastic surgeons approach treating the impact of aging.  It used to be thought that all aging changes could be corrected by just removing all the "extra skin" but now we know there is so much more to the process.  As we age we lose volume in certain areas of our face and without replacing this volume, no matter what other changes are made to the face, the face will appear "aged".  Fat transfers have become fairly standard in the rejuvenation process but as with any surgery, there are risks.  Some of the transferred fat may not survive and require a second procedure to add more volume.  Fat can lump or clump, and it does require a second operative site to act as the donor site.  Still, fat grafting has improved greatly and the risks and complications if performed by an experienced plastic surgeon are low.  Your plastic surgeon is recommending what many would consider the "state of the art" treatment for your concerns but still you should address all of your questions with your surgeon before proceeding with your surgery.  Hope this helps.

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