LAM FACIAL PLASTICS

Dear Dr. Lam,

I am 41 and thin and healthy. Two months ago I received fat grafting to the nasiolabial area. Specifically, only the CORNERS of the nasiolabial folds were injected, not the "folds" themselves, as the folds were nearly non-existent, while the corners were rather depressed.

Immediately after surgery and ever since, the area right above the folds has been greater in volume (beginning close to the corner and extending downward about half an inch in the direction of the folds, just above the nasiolabial fold). This has created very unattractive, aging, sharp, pronounced nasiolabial lines (as there is increased volume just above the folds). This increased volume is not diminishing and therefore does not seem to be swelling. Rather, it appears that the fat migrated out of the corners and into the area right above the folds. I am very unhappy, as I now look older and less attractive.

My questions are: (1) Is this common? (2) How did this happen (it was present even immediately after surgery)? (3) Can the migrated fat be removed? (4) Given the location of the migrated fat (the area right above the folds, but not in the folds themselves), how likely is it that the fat will be reabsorbed/metabolized/diminish on its own?

Thank you so much.

(1) Is this common? No, I have never seen it. (2) How did this happen (it was present even immediately after surgery)? Don't know but perhaps the fat was not placed where it was desired. (3) Can the migrated fat be removed? Very hard to do. It could be liposuctioned but really not easily. (4) Given the location of the migrated fat (the area right above the folds, but not in the folds themselves), how likely is it that the fat will be reabsorbed/metabolized/diminish on its own? Good chance. I typically say that the folds are a pretty difficult and useless area to fat graft in isolation. I think fat absorption in that area is relatively high.

Thank you so much, Dr. Lam. If the fat is reabsorbed, approximately how long do you think it will take?

hard to say. in the next few months to a year typically.