Correcting Fat Loss in IPL Damage: My Thoughts

Unfortunately, I have heard a lot on the Internet about facial fat loss following a laser treatment like intense pulsed light therapy, or IPL.  Fortunately, I have never seen a patient of mine with this outcome.  I think partly because this phenomenon is rare and partly because I use much lower-energy lasers than what are out there on the market so as to limit this risk.

There is great question of whether this phenomenon actually is real.  I personally believe that it is since there are enough people claiming that they have suffered this problem, and there are lasers on the market targeted to reduce excess fat.  The problem that I have on my forum relates to questions pertaining to the nature and evolution of this fat loss and how to manage it properly.  In general, I cannot answer these questions very well because I simply do not have enough experience to discuss the subject with authority.

If I am planning to perform a fat injections the problem is I do not know when exactly the injury has stopped.  It could be a few months, a year or greater, as some individuals claim ongoing fat loss.  In my opinion (and this is only conjecture), if there is damage, it should be self-limited if there is injury to the blood supply to the fat and should not be ongoing.  My best guess is that I would wait at least a year before contemplating performing Facial Fat Grafting on that individual.  Also, of course, I would like that person to clarify that he or she thinks that in fact the fat loss has stopped before considering transferring fat.

The biggest problem that I have encountered with individuals who have had an IPL injury to their fat is not physical but psychological.  Too often a patient becomes so obsessed with their fat loss that no treatment will ever make him or her satisfied.  They are living in the past and constantly evaluating in the mirror whether there is more fat loss or whether the surgery did enough to correct it.  This is a very dangerous thing because the individual can be psychologically unstable and cannot appreciate the improvement in the face.  In addition, some individuals experience further fat loss only due to stress from the initial incident causing them to age in appearance from stress rather than by physical insult.  Or after 1 to 2 years it is normal to lose a little more fat due to aging that could then be blamed on the IPL treatment.  For all of these reasons, treating patients who have reportedly lost fat after an IPL treatment can be difficult and problematic.

Sam M. Lam, MD, FACS is a board certified plastic surgeon in Dallas, Texas. To schedule a consultation please call 972.312.8188. To Learn more about Dr Lams’ plastic surgery procedures at or to ask Dr Lam a question please visit his plastic surgery forum.