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Fat Injection Gone Wrong


Fat injection, also called fat transfer, is a popular procedure to fill lips and wrinkles or augment anatomy such as the cheeks.  Many practitioners and patients love fat and have no problem with it.  On the other hand, there are many cases of fat injection that happens to patients and does not work out.  The main problems are usually asymmetry, lumpiness, over correction or the desire to simply have the procedure reversed.

Personally, I used to frequently perform fat injection.  The good thing about it was that it was the patient’s own tissue and abundant on most patients.  The bad thing about it was the fact that most of it is digested by the body after injection, so it requires multiple treatments.  Also, since most of it will go away, the surgeon has to significantly over correct the area because it will go down.  The duck lips for several weeks were a major drawback.

Then, overnight, the hyaluronic acid fillers (Juvederm, Restylane, etc.) became FDA approved in the USA and the entire landscape changed.  I liked the new fillers so much, I pretty much stopped injecting fat with the exception of severe facial defromities.  Among the great things about these new fillers was the fact that they could be reversed overnight.  You can’t do that with fat.

What goes in, must occasionally come out and that is where fat injection is a major drawback.  You can’t simply dissolve fat and many times it must be surgically removed.  I routinely get requests (many from the West Coast) to treat over done fat injections.  Sometimes this is really easy if the fat is superficial and sometimes it can be difficult or impossible if the fat is much deeper or around important nerves or blood vessels.

The video below shows a case that was rather straight forward where the patient has over treated areas of fat injection on her upper and lower lip.  I was able to recountour one area with micro liposuction and surgically remove the excess fat in the lower lip.

To find out more about cosmetic facial surgery by Dr. Joe Niamtu, III in Richmond, Virginia, visit


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Joe Niamtu III, DMD
11319 Polo Place
Midlothian, VA 23113

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