Inequalities and asymmetry
Bumps, depressions or different volume on both sides of the face. In reviews, this is one of the most frequent complications.
CONDITION / FACE
Complications after face lipofilling.
Complications after lipofilling of the face — problems after injecting own fat: unevenness, compaction, cysts, asymmetry or excess volume. Most often, this is a planned situation. A rare, but the most dangerous complication is blockage of a blood vessel with fat, which threatens blindness or stroke.
CONCEPTUAL VISUALIZATION- What it is
- Problems after injecting your own fat into the face that go beyond normal healing.
- How common
- In the review of 43 studies (4,577 patients) — 2.27% of complications; the true frequency is unknown.
- Most often
- Asymmetry, unevenness, prolonged swelling; less often - compaction, cysts and excess fat.
- The most dangerous
- Rare blockage of a blood vessel with fat: blindness, stroke. With such signs - 103.
01 / WHAT IS ITWhat is
What is
complications of lipofilling.
Lipofilling is an operation in which fat is taken from one part of the body (abdomen or thighs) with a thin tube, cleaned and injected into the face in small portions to add volume. More than half a million face lipofillings are performed every year in the world.
Some of the changes after surgery are normal healing. According to the NHS, bruising and swelling last for several weeks, and the final result lasts up to 6 months, as some of the fat is absorbed in the first months.
Complications are anything that goes beyond these: bumps, asymmetry, compaction, sebaceous cysts, fat loss, excess volume. The true frequency is unknown: complications are defined differently and are not always described.
A rare but most dangerous complication is the ingress of fat into a blood vessel (embolism). Fat can block an artery in the eye or brain. This is an emergency: you need help in a hospital, not a plastic surgery clinic.
This is general information. The doctor will tell you what will suit you after the examination.
02 / SIGNSWhat can
What can
go wrong
Symptoms depend on the type of complication. Most appear gradually, over weeks or months.
Seals and nodules
A hard "ball" can be felt under the skin, most often under the eye or on the cheek. In a series of 48 patients with such complaints after lipofilling of the lower eyelid, 54% had a single nodule.
Oil cyst
A dense formation under the skin that does not go away. In a series of operations on the lower eyelids, cysts appeared on average 236 days after lipofilling.
Fat loss
Part of the transplanted fat dies (fat necrosis), and in its place, seals or cysts form.
Excess after gaining weight
Cheeks or another area that noticeably increases when a person gains weight: the transplanted fat behaves like the place where it was taken from.
The skin
Prolonged swelling and redness, vascular "stars", exacerbation of acne. This usually does not require surgery.
03 / REASONSWhy do they arise?
Why do they arise?
complications
Part of the reasons is related to how and where the fat was injected, part - to the characteristics of the patient himself.
How the fat was distributed
During repeated operations, the fat that had formed nodules under the eye was found separately from the eyelid's own fat — in particular, in the muscle around the eye.
Absorption
Some fat does not take root: in a review of 43 studies, an average of 41.63% of the injected volume was retained. Therefore, the result may differ from the expected one.
Gaining weight
Transplanted fat retains the properties of the area from which it was taken. If you take it where the fat is the most, the risk of excessive weight gain may be higher.
Pressure and diabetes
In one series of operations on the lower eyelids, oil cysts formed more often in people with high blood pressure and diabetes.
Fat in the vessel
Severe vascular complications are most often described after the injection of fat between the eyebrows and temples; with eye complications, the most frequent area was the forehead.
04 / SEEK MEDICAL ADVICE
When to seek medical advice?
Irregularities, thickening, cysts or asymmetry that appeared weeks or months later are a planned situation, they usually do not require emergency care. But if during or shortly after lipofilling, vision suddenly worsened or signs of a stroke appeared, it could be a blockage of a blood vessel with fat. Do not wait for it to pass and do not drive alone - call 103.
103 immediately if:
- suddenly stopped seeing in one or both eyes;
- severe pain in the eye suddenly appeared;
- sudden blurred vision or double vision;
- eyelid suddenly drooped;
- the face suddenly turned to one side;
- sudden weakness or numbness of an arm or leg on one side;
- speech was suddenly disrupted;
- confusion or loss of consciousness;
- sudden severe headache.
Do not delay a visit to the surgeon:
Immediately: call the surgeon who performed the lipofilling, and if this is not possible, go to the reception department if the skin at the injection site turns white, blue or darkens and hurts: this may be a sign of impaired blood flow. On the same day: to the surgeon if the eye hurts (mild, but does not go away) or the growing area swells, reddens and hurts (possible infection). If this is accompanied by a very high temperature or chills, frequent heartbeat or breathing, confusion - immediately go to the reception department or call 103. Planned: irregularities, compaction, cysts, asymmetry, excess volume — the final result of lipofilling takes up to 6 months, but you can see a doctor even earlier.
05 / DIAGNOSTICSAs defined,
As defined,
what to treat
- Conversation and documents
When, where and in what areas was fat injected, how many sessions were there, did the weight change; statement and photo before the operation, if any.
- Review
The surgeon evaluates the contour and symmetry of the face, feels the seal, looks at the skin.
- Ultrasound if necessary
It can help to understand where the lump is and whether it is a cyst, dead fat, or excess.
- Other examinations as needed
If it is not clear what exactly was injected earlier, or there are signs of infection, the doctor will order additional examinations.
06 / TREATMENTHow we treat
How we treat
complications
Treatment depends on what exactly happened. Serious vascular complications are treated immediately in the hospital; irregularities, cysts and excess are corrected as planned when healing is complete.
01
Clogged vessel
Immediately, in the hospital.
- Why is this serious?
- In a review of facial lipofilling complications, such cases required neurological or neurosurgical care and often resulted in permanent disability or death.
- eye
- There is no reliable treatment for retinal vessel occlusion. In a review of 113 severe vascular complications, successful treatment was described in only one case of occlusion of the eye artery and one case of cerebral artery occlusion.
- What are they trying?
- In a series of 12 patients with blindness after lipofilling, blood flow in the eye artery was restored through a catheter; vision improved in three. Such assistance is provided in large hospitals, so time is crucial.
02
Seals and cysts
Planned.
- Oil cysts
- According to a series of lower eyelid surgeries, safe and effective methods are steroid injection, needle puncture of the cyst, liposuction, and excision.
- Nodules under the eye
- They are removed during surgery. In a series of 48 patients, surgeons described exactly where in the tissues such fat lies and gave recommendations for treatment; the doctor chooses the method after the examination.
03
Inequalities, asymmetry, excess
Corrective operation.
- Repeat correction
- On systematic review, excessive volume, fat loss, cysts, irregularities, and asymmetry require corrective surgery.
- Exactly how
- The hollows are filled with their own fat, and the excess is removed by liposuction. Sometimes several steps are required.
- Gaining weight
- Transplanted fat reacts to changes in weight, so this is taken into account when planning a correction.
04
Skin and swelling
- Without surgery
- Prolonged swelling or redness, according to a systematic examination, does not require surgical treatment.
- Dying skin
- If the area of skin has died after the vessel has been blocked, the wound is cared for until it heals, and the defect is closed with its own tissues if necessary.
07 / AT THE VALIKHNOVSKYI INSTITUTE
How
How
we treat it.
Complications after lipofilling of the face are treated at Dr. Valikhnovskyi's Institute of Surgery in the direction of "Treatment of complications of aesthetic operations" — in particular, when lipofilling was done in another clinic. Acute vascular complications are treated immediately in the hospital; the clinic is responsible for further tissue recovery.
CLINIC SERVICE
Treatment of complications of aesthetic operations
Skin necrosis, dehisced wounds, capsular contracture, liposuction irregularities, and gross scarring.
View service
What we do for this condition
- Lipofilling — depressions and asymmetry are filled with their own fat; it is also injected under the scar tissue to soften it.
- Repeated liposuction — excess fat is removed to even out the contour.
- Dissection of scar tissue - threads that tighten the skin and form hollows, dissect.
- Cleaning the wound and dressing — if the area of the skin is dead, the dead tissue is removed; small areas on the face often heal under dressings.
- Perforating flaps — a thin flap on one small vessel covers the defect on the face with a fabric similar in color and thickness.
- Excision of scars — a rough scar is cut out and stitched using a different technique.
Rostislav Valikhnovskyi
Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovskyi Institute of Surgery.
How treatment works with us
- Photo onlineSubmit a facial photo now and, if available, a lipofilling statement and photo.
- ConsultationContour and symmetry review, evaluation of seals; if necessary — ultrasound.
- PlanWhat to remove, what to add and in what sequence; are multiple stages required?
- TreatmentRepeated lipofilling, excess liposuction, dissection of strands — depending on the complication.
- RecoveryReviews after correction; the final look is assessed not immediately, but after months.
08 / QUESTIONS AND ANSWERSCommon
Common
questions
Short answers. What is right for you, the doctor will tell you during the consultation.
Is it possible to be treated with you if lipofilling was done in another clinic?
Yes. The doctor assesses what is now and makes a plan. Take a statement from that clinic and a photo before the operation, if you have them.
After lipofilling, the face is swollen and uneven — is this a complication?
Not necessarily. According to the NHS, bruising and swelling last for several weeks, with the final result lasting up to 6 months. If the swelling grows, reddens and hurts, go to the surgeon on the same day.
A hard ball appeared under the eye. What is it?
Most often - a nodule from transplanted fat or an oil cyst. They are treated by injection, puncture, liposuction or excision; what will suit you, the doctor will tell after the examination.
Why did the face "correct" with me?
Transplanted fat retains the properties of the area from which it was taken and can increase as the person gains weight. Excess can be removed.
How dangerous is face lipofilling for vision?
Obstruction of the vessel of the eye with fat is rare, but it is the most serious complication. If your vision suddenly worsens or your eye hurts a lot during or shortly after lipofilling, call 103.
When can inequalities be corrected?
Usually after the result has stabilized: part of the fat is absorbed in the first months, the final look is up to 6 months. The doctor will tell you what to do and when during the examination.
Sources
14 sources · systematic reviews, meta-analyses, patient series and NHSshowCollapse
- Facial Fat Grafting (FFG): Worth the Risk? A Systematic Review of Complications and Critical AppraisalJournal of Clinical Medicine, 2022doi:10.3390/jcm11164708 ↗
- A systematic review of the effectiveness and complications of fat grafting in the facial regionJPRAS Open, 2019doi:10.1016/j.jpra.2018.12.004 ↗
- Severe Vascular Complications Caused by Facial Autologous Fat Grafting: A Critical ReviewAnnals of Plastic Surgery, 2021doi:10.1097/SAP.0000000000002691 ↗
- Ophthalmic Complications Following Facial Autologous Fat Graft Injection: A Systematic Review and Meta-AnalysisAesthetic Plastic Surgery, 2022doi:10.1007/s00266-022-02924-5 ↗
- Cerebral Complications Following Facial Autologous Fat Graft Injection: A Systematic Review and Meta-analysisAesthetic Plastic Surgery, 2024doi:10.1007/s00266-024-04268-8 ↗
- Blindness following cosmetic injections of the facePlastic and Reconstructive Surgery, 2012doi:10.1097/PRS.0b013e3182442363 ↗
- Exploring Superselective Intraarterial Thrombolysis for Autologous Fat Injection-Induced Vision LossAesthetic Surgery Journal, 2024doi:10.1093/asj/sjae005 ↗
- Facial Hypertrophy as a Complication of Weight Gain in Autologous Fat Graft Patients: Considerations and RecommendationsAesthetic Surgery Journal, 2023doi:10.1093/asj/sjad196 ↗
- Oil Cyst Formation after Lower Blepharoplasty with Fat GraftsAnnals of Plastic Surgery, 2022doi:10.1097/SAP.0000000000003086 ↗
- The Management of Lumps, Bumps, and Contour Irregularities of the Lower Eyelid and Cheek After Poor Outcome Fat TransferAesthetic Surgery Journal, 2023doi:10.1093/asj/sjad025 ↗
- Surgical fat transferNHS, 2023nhs.uk/tests-and-treatments/cosmetic-procedures/cosmetic-surgery/surgical-fat-transfer ↗
- Vision lossNHS, 2025nhs.uk/conditions/vision-loss ↗
- Symptoms of a strokeNHS, 2024nhs.uk/conditions/stroke/symptoms ↗
- CellulitisNHS, 2024nhs.uk/conditions/cellulitis ↗
The figures on the page are from these sources.
Something is wrong
after lipofilling?
Send a photo of your face and an extract from the clinic where lipofilling was done. The doctor will tell you what can be fixed and when.