Facial fat grafting involves transferring an individual’s own fat from one area of the body to areas of the face that have lost volume due to aging, trauma, weight loss, surgery, or other causes, to improve facial contour and symmetry. Because the transferred fat requires time to establish blood supply and integrate with surrounding tissues, careful attention during the recovery period is essential to protect the grafted fat and promote proper healing.
Following your surgeon’s post-operative instructions plays a crucial role in preventing complications and achieving optimal results.
Post-Operative Instructions for Healing
After the surgery
- Stay in bed and continue resting for the next 24 hours after getting home. Only get up to use the restroom with help.
- Sleep on your back with your head elevated on 2 to 3 pillows for the first couple of weeks to minimize facial swelling and protect grafted areas. Avoid sleeping on your side or face down.
- The initial 48 hours after the procedure are crucial for grafted fat cells to integrate with the surrounding tissue. It is crucial to exercise caution during this period. Avoid touching, massaging, rubbing, or pressing the treated area, and try to maintain an upright position.
- Swelling, bruising, and discomfort are at peak during the first few days after surgery. They will begin to subside gradually over the following days.
- Avoid pullover clothing for the next few days. Pulling clothes over your head can put pressure on the facial stitches or stretch them, resulting in pain and swelling. It is best to wear shirts that button or zip up from the front or back.
- Do not plan any dental procedures for at least a month after surgery or unless your surgeon clears you.
- You may be able to wear your glasses after surgery, but do no put contact lenses if you had surgery on the eyelids. It is important to be careful and avoid putting pressure on your newly grafted face.
- Do not use ice on the facial areas that have undergone fat grafting or fat transfer, as ice can affect the success of the grafted tissue.
- Do not lie in bed all day. Get up the next day and resume light movement, such as taking light walks around the house and moving your arms and legs. This is important for normal blood circulation.
- Avoid going for a facial massage in the first few weeks or months following fat transfer. The grafted fat needs stability to attach with the surrounding tissues.
- Wash your face gently with a mild soap and gently pat it dry with a clean, soft towel. Do not use harsh cleansers on the face as they can damage the incisions and lead to swelling and pain.
- Do not apply any creams, ointments, or makeup on the grafted areas until advised by your surgeon.
Caring for your incisions
- Dissolvable sutures are usually used for facial fat grafting.
- You will notice small incision lines on the areas where fat was harvested. Your surgeon will put a tape dressing over these incisions. Do not remove them on your own. Your surgeon will remove the tapes and the necessary stitches at your post-op appointment.
- Avoid direct exposure to the operated areas for the next six weeks. Apply at least SPF 30 or higher when going outdoors and use a wide-brimmed hat to protect the treated area from harsh sun rays. Even a mild sunburn can irritate incisions, cause permanent scar discoloration, and delay healing.
- Your surgeon will recommend applying an antibiotic ointment to the fat transfer entry points, which resemble a puncture mark, till they have completely healed. Follow your surgeon’s instructions regarding ointment application.
- Do not smoke or take any nicotine products after surgery. Nicotine can constrict blood vessels, which reduces blood flow to the healing tissues. It can result in complications and jeopardize your surgery results.
It is important to follow your surgeon’s post-surgical instructions carefully. Your final result will depend on how well you care for your treated area.
Donor area care
The area of the body from which fat is extracted for harvest in the face is called the donor area. Common donor areas include the abdomen, thighs, or flanks.
- The donor sites may be covered with small dressings. It is important to keep the dressings dry and clean to prevent infections.
- Your surgeon may recommend you wear a compression garment to support the donor area and prevent swelling and discomfort.
- Mild soreness and bruising are normal for the next few days.
- Avoid heavy exercises for 2 to 3 weeks.
- Wear loose, comfortable clothing that does not press on the donor sites.
- Avoid tight waistbands if fat was taken from the abdomen or flanks.
What to expect?
- Pain – You will experience tightness, pressure, shooting pain, soreness, and fatigue for several days to weeks after surgery as you recover.
- Swelling – Swelling on your face usually lasts 1-2 weeks, during which the injected fat will be absorbed. Swelling varies from person to person and usually improves with rest and keeping your head elevated.
- Bruising – Expect to have bruising on your face. Most bruises heal in about 2 to 3 weeks. The bruises will change their color from purple to a yellow-green shade as they start fading.
- Drainage – Some mild bleeding and drainage are not unusual at the incision sites or puncture areas for the first few weeks after surgery. Use a light gauze or a dressing to absorb this fluid.
- Itching – Itching at the puncture site and the incision site for the next few days is normal. You can take some medication to help with itching.
- Sensory changes – You may feel numbness around newly treated facial area. It results from temporary irritation of the tiny sensory nerves during the injections and usually subsides within a few weeks as the tissues heal.
- Weakness or dizziness – Some patients experience weakness or dizziness after surgery, especially when they try to stand up too quickly. Sit up or stand slowly to prevent falls. Staying hydrated can help reduce feelings of lightheadedness.
Don’t be alarmed if you notice lumps, or asymmetry in your face. This is due to post-procedure swelling and small collections of grafted fat settling under the skin. These will improve as healing progresses.
What to eat?
- Start with a light, low-fat diet once your doctor approves after surgery. Stick to soft foods like soups, yogurt, smoothies, mashed vegetables, and soft fruits that are easy to chew, as you don’t want to place excessive strain on the newly treated facial muscles.
- You can return to your normal diet as you start feeling better and regain your facial muscle strength.
- Avoid spicy, greasy, heavy, fried, and processed foods.
- Stay away from alcohol for at least 2 weeks or as directed by your surgeon.
- Drink plenty of water, at least 6 to 8 glasses a day. Surgery can cause dehydration, which can lead to dizziness or nausea. Make sure you are well-hydrated.
Medications
- Take all your medications, including antibiotics, pain-relieving medications, and ointments as prescribed by your surgeon to prevent infections and discomfort.
- Do not take any other medication without first consulting your doctor, especially blood thinners.
- Only use the specialized products your surgeon has prescribed for your incisions. Unauthorized products or home remedies can result in permanent scarring and skin pigmentation.
- Do not take your medications with alcohol.
Showering after facial fat grafting
- You may shower 24 hours after surgery. Follow your surgeon’s instructions on washing your face.
- Do not submerge incisions under water until the incisions have healed completely and no scabs are left.
- Stay away from swimming pools, tub baths, and until your incisions have healed, or you have been cleared by your surgeon, which may take around 2 to 4 weeks.
Physical activity
- You can resume normal daily activity a few days after surgery. Avoid strenuous exercise, bending, straining, and lifting anything heavier than 5 pounds for at least two weeks, as it can increase swelling, place pressure on the treated areas, and impact healing.
- Light exercises, such as walking and gentle arm and leg movements, can be resumed 2 to 3 weeks after surgery to prevent blood pooling and clotting. Start easy and build back up to your previous exercise levels once you feel comfortable, and as advised by your surgeon. Swelling may temporarily worsen with exercise, so it is important to avoid any activities that can cause trauma to the treated areas during the early recovery period.
- Most patients require 5 to 7 days off work, depending on their job responsibilities and the level of physical effort their job demands. If your job involves meeting people frequently or being outdoors, you may need additional time off work while the swelling and bruising subside. It is best to start work part-time and increase your hours as you feel comfortable.
Some of the fat is naturally absorbed in the first few months. Some patients may require a multistage fat grafting session for optimal results. It usually takes 3 to 6 months to see the final results of your surgery. You will also notice subtle improvements in skin quality due to the regenerative properties of the stem cell-rich fat transfer.
Call your doctor’s office if you notice unusual symptoms, changes in facial features, or changes in vision or sensations that do not feel normal. A healthcare provider can evaluate these symptoms and help address any concerns to support proper healing.
Conditions that require emergency care
Call 911 immediately if you experience any of the following:
- Intense pain that does not get better with pain medications
- Increased or sudden onset of swelling on your face or donor areas
- Redness or warmth on the incision site
- Excessive drainage on dressings
- New or worsening facial asymmetry
- Incisions that appear to be opening
- Bleeding that does not stop with pressure
- Lightheadedness or dizziness
- Allergic reaction, such as rash or itching
- Temperature above 101.8°F
- Shakes and chills
- Breathing issues
Timely medical attention plays a crucial role in minimizing issues and ensuring smooth recovery.