Can asymmetric fat graft on nasolabial folds be removed by liposuction or a facelift? (photo)

It is difficult to say whether your concerns are the result of a misplaced or asymmetric fat graft or simply the result of normal age-related sagging in the lower face. A single two dimensional photograph is difficult to accurately assess. It is indeed possible to safely remove a small amount of fat by syringe liposuction using a very small micro-cannula, although minor irregularity is a potential complication. In some areas of the face it may be safe to use a fat dissolving agent such as Kybella, although this is an off-label usage and caution is advised. Finally, I would suggest that you step back from the situation and consider an overall re-assessment of your face. It may be that the treatment was simply inadequate to address your aging concerns. Best wishes, Dr. Ridenour

It is not uncommon to see patients coming with excessive fillers or fat in the nasolabial area. If the retaining ligaments that form the nasolabial folds are not released properly by a subcision, the injected fat can displace in the lip or the cheek and create an unnatural bulging. The HA fillers can be dissolved and fat can be removed very carefully with a micro cannula. The question is how much to remove or to dissolve to correct the problem and not create another deformity. If the fat injection was done by a qualified and experienced plastic surgeon, he or she could remove small amounts of fat with a micro cannula, incrementally and you would have to understand that this might have to be done more than once. This could correct the excess without producing an unfavorable result. This is why all these simple procedures should be done by the most qualified and experienced plastic surgeon who can take care of these types of complications.

After reviewing your photo, I will have to answer your question based on my thoughts about your question only. Yes, fat can be removed with a microcanula and I have performed this several times as occasionally the fat transfer procedure work "too well" and more fat remains then was expected.

Gosh I wish you had included more photos!   The short answer to your question is that, yes,  grafted fat can under some circumstances be removed with liposuction.  But the results would not necessarily be perfectly gratifying in all cases. It all depends on your very specific presentation. You do not specify your age, or if you have had a facelift, etc.  One important point is that nasolabial folds are universally rather asymmetrical.  Look at some models in magazines.  One side is typically shallow, the other is deep.  One side is typically straighter, the opposite more curved.  If one of your side is truly overcorrected with fat grafting then removal seems your only option.  But is it possible your concern could be addressed by some other procedure such as grafting the other smaller side, grafting your cheeks more to make the surrounding area more full, lifting the jowl with a lift, or even perhaps buccal fat pad excision.  If you provide more photos we could provide a better answer.

Thank you for your question. Unfortunately, it is impossible for me to advise you on this concern based on a single image. I can tell you generally that it is very difficult to remove fat after a grafting procedure. It is likely that your best option for adjusting the asymmetry will be injections of dermal fillers to the area that is lacking fullness. Liposuction is not a good choice for this area. I recommend you schedule an in-person assessment with a board-certified plastic surgeon who can perform a full examination and then advise you accordingly.