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January 10th, 2014

Questions and Answers with Dr. Burns

Q: Is micro-liposuction to facial areas a viable step to take to remove some of the fat from previous fat injections? Has removal of placed fat in these areas been done successfully? Any other options?

A: I am sorry to hear of your situation, especially since it is so difficult to treat. Facial liposuction is to be avoided if at all possible as any irregularity is noticeable. With such treatment you might be changing one problem for another. The good news is that it doesn’t  sound like you have been out a full  year from your fat injection.  Usually there is quite a bit of fat resorption over the first year, which is one of the problems with fat injection, but in your case that could be a blessing.  If it does last a year then it is permanent. Liposuction with small cannulas in expert hands is certainly one option of treatment.

There is a new treatment of injection to melt fat, Kythera, but it is painful and causes swelling  temporarily that can be significant. Such treatment also has to be repeated multiple times reportedly. It is not currently approved in the US but should be shortly. You might look into this in the future, but hopefully the fat will resorb more to your liking.

For all the reasons mentioned above, I am not a fan of fat injections in general. Although this technique remains popular with many physicians, fat injection has many issues. There is a high variability in resorption rate. Granulomas(painful red nodules) can occur and obviously issues like the one you are describing for yourself can happen. You also have to deal with a sometimes painful harvest site location.
Today there are amazing alternatives with injectable fillers. Although they have to be repeated, several can last for 1 to 2 years and no general anesthesia is required.  A new filler, Voluma can last 18 months to 2 years and is reversible if too much is put in and you find yourself in a similar situation to the one you describe in your question. My patient population is growing exponentially each year with very satisfied patients who come in for the excellent filler and injectables offered today.