Question:
I had fat transfer a few days ago and I feel like the doctor really overfilled my cheeks and the folds around my nose. I look horribly swollen and piggish. Will this improve or is there some way to reverse what has been done?

Answer:
Considering you are only a few days out from the procedure, I would expect that this is quite normal in that we are not only going to have a bit of overcorrection due to the amount of fat that is injected, but since you are only a few days out you are essentially at the peak of swelling and the combination of the swelling and over-injection of fat can lead to a very overinflated appearance.  Over the next few days the majority of this swelling is going to subside and though you will still be slightly overfilled with the fat, you should have a relatively normal appearance and then over the next few months a percentage of this fat will resorb and long term you should have an excellent result.   

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Question:
Are there any side effects associated with fat injections for facial rejuvenation?

Answer:
The most common side effects from fat injections for facial rejuvenation are temporary swelling and a mild over-inflation of the area due to the fact that we know that we are going to be resorbing at least half of the injected fat over time.  There also can be granulomas, which are small inflammatory nodules that can form.  These typically respond to injections of a low-dose steroid and obviously depending on the injection technique you can end up with lumpiness or nodules due to the fat infiltration process.

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Question:
I’ve got horrible dark circles and hollowness beneath my eyes. Is it true that fat can be transferred from another part of my body to fix this?

Answer:
Yes, fat can definitely be transferred from another part of your body and then injected below the eyelid to fill in some of the area that lacks volume.  This, in fact, is the most common area that I personally perform fat grafting and I have had excellent long-term results by layering very small quantities of fat across the entire area.  It is a rather subtle improvement, but when you look at the before and after pictures the results can be extremely impressive for what small volume of fat actually remains in the area.

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Question:
I would consider fat transfer but are the results really permanent?

Answer:
I find structural fat grafting or fat transfer an extremely valuable tool in my ability to rejuvenate patients, but I typically use it as an adjunctive tool to other procedures.  In other words, I will use fat grafting to the mid-face and cheek area at the same time I am doing a lower lid blepharoplasty or a facelift.  This gives a very subtle yet very significant enhancement to the patient’s facial features and yes, I truly believe that at least a portion of the fat could be considered a permanent filler since about one-third to maybe one-half of the fat that is injected should develop its own blood supply and become viable transplanted fat that will stay there for an extremely long time if not permanently.

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Question: I’ve seen some results of fat transfer that look great but other times the person looks too puffy or bloated. How do you avoid a puffy look?

Answer: The simplest way to avoid a puffy or bloated look with fat grafting is to simply not put in too much fat.  My personal opinion is that there is a "happy place" for fat grafting where we get to add a small amount of volume and make somebody look refreshed, and yet we do not need to add so much volume that they look puffy or swollen.  I will most commonly perform fat grafting in association with other surgical procedures, such as lower lid blepharoplasties and facelifts, and I, therefore, typically place relatively small amounts of fat compared with surgeons that try to rejuvenate the entire face simply by adding volume with fat grafting.  I have found that this combination approach allows me to create extreme rejuvenation while maintaining a very natural and healthy appearance. 

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