Ocular Swelling after Forehead Fat Graft

ABSTRACT

BACKGROUND: Facial fat grafting is a common cosmetic surgery for facial contouring. Although it is considered a very safe procedure, there are several reports about complications after fat grafting. Eye complications are very rare, but do exist. The author has treated cases of eyelid swelling after forehead fat grafting with conservative or surgical treatment. METHODS: From February 2010 to April 2014, the author treated five women (mean age, 35 years; range 28-52), who developed eyelid swelling (both, n=3; unilateral, n=2) approximately 2 weeks after forehead fat grafting. Symptoms included pain, foreign body sensation, recurrent swelling and redness, unilateral or bilateral ptosis, and palpable lumps. Three were acute cases treated within 1 month, and the other two were chronic cases, which occurred 4 and 28 months after the fat graft. RESULTS: Conservative treatment (Lasix, antibiotics, steroids) was used for two patients. The other three patients were treated with direct fat extraction or lump excision through the double eyelid crease line. Histological examination identified the excised specimens as lipocysts or liopogranulomas. All patients fully recovered, despite transient ptosis for several days immediately after the operation. CONCLUSIONS: Eyelid swelling after forehead fat graft can be successfully treated with either conservative or surgical treatment. Although few studies have reported eyelid swelling after fat grafting, this complication may become more common, in the future, as facial fat grafting becomes more popular. This treatment modality should be helpful to the plastic surgeons faced with these unpleasant complications.