Can excess surviving fat be removed after fat grafting?
Can excess surviving fat be removed after fat grafting?
Yes. The key is to determine how much fat has survived and in which layer, then correct only as much as needed, rather than simply removing a large amount.
Excessive removal can cause recurrent hollowing, so the process is closer to redesigning volume than simply removing fat.
Which situation applies to me?
My situation | Likelihood of correction | Approach
A protruding bulge at the graft site | Very high | Selectively remove only the areas that need correction
Much more fat has survived on one side | High | Fine adjustments to balance the two sides
Multiple previous fat grafting procedures | Moderate | Plan after assessing the graft layers & degree of fibrosis
Fat has formed firm clumps | Moderate to high | Assess both fat and the possible presence of fibrous tissue
Swelling is still present after grafting | Defer assessment | Monitor until swelling subsides
Why can assessment be difficult?
Fat graft survival cannot be predicted with 100% accuracy. Even when the same amount is grafted, the amount that survives can vary with circulation, tissue condition, and movement in each area.
In thin-skinned areas such as the forehead or front of the cheekbones, more fat surviving than expected can create bulges or a heavy facial appearance.
This is more likely to reflect excessive surviving graft volume than weight gain.
Immediately after surgery, swelling and inflammation also often make the area look larger than it actually is.
For this reason, the usual approach is to monitor progress until graft survival has stabilized before deciding on correction.
Removal methods depend on the condition
- Selective removal: The most common approach removes only the areas of excessive graft survival to create natural-looking volume.
- Correction of both fat and fibrous tissue: When repeated grafting has led to fibrous tissue and firmness, addressing the tissue condition as well as removing fat is important.
- Planning for balance between the two sides: When more fat remains on one side, adjusting balance with the overall facial contour in mind offers greater satisfaction than removal alone.
[ Actual surgical footage, edited with reduced saturation to lessen viewing discomfort ]
UVOM Plastic Surgery's approach
- Precise dissection with a 4K endoscope: A 4K endoscope, uncommon in Korean plastic surgery clinics, provides a magnified view of deep fat and surrounding tissue so that areas of excessive graft survival can be selectively targeted.
- Removal using ultrasound equipment: A small incision reduces concerns about scarring, and ultrasonic vibration allows effective removal of foreign material without damaging surrounding tissue.
- Preserving normal tissue first: We correct only excess surviving grafts while preserving as much normal fat and as many blood vessels as possible to prevent recurrent hollowing from overly aggressive removal.
- Planning facial proportions as well as removal: We consider the overall balance of the face, reducing excess volume while retaining volume where it is needed.
Frequently asked questions
Q. Can grafted fat be removed even many years later?
A. Yes. Over time, surviving grafted fat becomes tissue similar to ordinary fat, so the passage of time itself does not prevent removal. However, after multiple grafting procedures, it is important to check for fibrosis as well.
Q. Can all of it be removed at once, as with liposuction?
A. This is not recommended because removing more than necessary can cause hollowing or asymmetry. The principle is to correct only as much as allows a natural contour to be maintained.
Q. When can correction be considered?
A. Assessment is usually made after swelling has subsided and graft survival has stabilized. The exact timing varies with recovery speed and the graft site, so a clinical assessment is the best way to determine this.
Q. Will fat grow back after removal?
A. Removed fat cells do not grow back. However, the size of the remaining fat cells can change with changes in weight.
If you are concerned about excessive fat graft survival, call 02-545-3700 or contact UVOM Plastic Surgery on KakaoTalk.