Wrinkles, fine lines, and age spots are not the only visible signs of aging. As we get older, our faces also lose volume, due to factors like collagen depletion and the centralization of body fat. Hormonal and metabolic changes cause fat cells to gradually migrate from our extremities (i.e., our hands, feet, and face) to our abdomen, resulting in cheek and under-eye hollows. Fortunately, just as there are many different wrinkle-removing treatments available today, there are multiple solutions for the loss of facial volume. One of the most effective of these is facial fat grafting.
How Does Facial Fat Grafting Compare to Dermal Fillers?
Patients who wish to address a loss of facial volume are presented with two primary choices: Facial micro- fat grafting and injectables such as Restylane, Juvederm and other facial fillers. Understanding the pros and cons of both types of procedures is essential to maximizing your chances of successful treatment. The differences between facial fat transfers and dermal fillers are outlined below:
Most volume-enhancing dermal fillers are comprised of gel containing hyaluronic acid (a synthesized version of the natural hyaluronic acid found in the human body). Once fillers are injected below the skin, they both directly “fill in” lines and hollows and improve the skin’s tone by boosting collagen production. Some patients prefer this procedure (rather than surgery) because it’s extremely convenient. The injections can be administered in-office and the patient can return to work the same day. No healing time is required and there is little risk of complications like bleeding, extensive swelling, or infection.
Fillers are not without their downsides, however. First and foremost, they’re temporary. Depending on the filler the patient chooses, they can last from six months to about one year, then they need to be re-administered. While dermal filler appointments don’t represent a serious inconvenience time-wise, having regular “top ups” of hyaluronic acid can become very expensive over the years. Though most fillers are made from naturally-derived substances, they don’t have exactly the same consistency as fat. As such, some patients feel they are not as natural-looking as genuine fat deposits. Ultimately, it’s a matter of personal preference.
Fat grafting, on the other hand, relies on the transfer of fat that is harvested from another part of the body. (This can be done under local anesthesia or sedation)Fat cells will usually be taken from the abdomen or thighs, purified using a specialized process, then injected directly into the areas of the face that require treatment. While this procedure is technically a surgical process, it’s a minimally invasive one. Fat grafting requires only a very small incision (in order to insert the fat-harvesting tube). As such, there is very little risk of scarring, swelling, bleeding, or infection. There is also no risk of adverse or allergic reactions, whereas there is a very small risk of these occurring when injecting any substance that is foreign to the body. In summation, when performed properly, facial fat transfer is very safe—and unlike dermal fillers, it’s capable of creating permanent results. Patients also report that fat injections look and feel slightly softer and more supple than injected fillers. They also improve the quality of the overlying skin.
The main caveat to be aware of when weighing the option of facial fat grafting against dermal fillers is the amount of surgical skill required. While facial fat grafting offers important advantages in the form of long-lasting and natural-looking results, it takes a lot of expertise and training to perform correctly and artistically. You will therefore need to do your due diligence when selecting a plastic surgeon to perform this procedure. The surgeon you choose should be board certified by the American Board of Plastic Surgery and ideally a member of the American Society for aesthetic Plastic Surgery, and have a history of performing successful facial fat transfers. Remember: You should always ask to see a surgeon’s portfolio and verify his or her credentials and references before booking any surgical procedure.
Finally, if your plastic surgeon suggests dermal fillers rather than fat transfer for treating a certain area of the face (such as the lips), it’s best to listen to him or her. Dermal fillers are capable of producing more precise results when working with delicate, hard-to-sculpt facial features.
How Effective is Facial Fat Grafting?
Facial fat grafting is usually effective, but it’s important to understand that it can be slightly less reliable than injectable fillers. This is because some patients’ bodies tend to re-absorb injected fat cells over time, thereby mitigating the results of the fat transfer procedure. Unfortunately, it’s impossible to tell what percentage of fat cells will be re-absorbed by a given body prior to treatment. In most patients 30-50% of the fat is retained permanently. Some may retain more. None of the injectables fillers last permanently.
Once again, however, choosing a highly qualified and experienced plastic surgeon will help ensure the permanence of this procedure’s results. By using the latest fat purification techniques, removing fat correctly, and inserting it adeptly, your surgeon can greatly increase the chances that most of the transferred cells will remain in place. Performing a fat transfer successfully is all about keeping the harvested fat cells viable. Treating them carefully and preventing them from becoming damaged during the harvesting and insertion process is of paramount importance.
Where Can Fat Be Injected into the Face?
Fat is usually injected into the nasolabial folds (the crevices that extend from the corners of the mouth to the nose), the area around the eyes, and/or above or below the cheekbones. However, because fat is so versatile, it can potentially be injected into other areas as well. Some patients opt to have fat injected into their forehead, neck, chin, lips, jaw area, and/or glabella (the space between the brows). Some surgeons are even using facial fat transfer techniques to fill in acne scars and scars sustained via injury.
Can I Have a Facial Fat Transfer along with Liposuction?
Absolutely. Some patients who are interested in having liposuction performed on their abdomen or thighs (for body sculpting purposes) opt to have the harvested fat purified and transferred. In addition to transferring the harvested fat to your face, your surgeon should be able to transfer some to your hands as well in order to correct age-related thinning of the extremities.
Whenever you’re thinking of having one procedure done, it’s a wise move to ask your surgeon about the possibility of combining it with additional procedures. In addition to pairing well with liposuction, facial fat transfers are usually incorporated into facelift surgery to produce a natural, fresher appearance. Botox and lip injections can also be used to put the “finishing touches” on the patient’s face. By combining a number of different procedures, you can essentially combat all of the visible signs of aging from multiple angles. This tends to lead to the most pleasing, dramatic, and natural-looking results of all.
Who Makes a Good Candidate for Facial Fat Transfer?
Facial fat transfer is a minimally invasive procedure, but it’s still a form of surgery. As such, you’ll need to make sure that you meet the following criteria before you book a consultation for this procedure:
- You will need to be in good health and a nonsmoker. Even small incisions can create problems for patients with certain health conditions, such as uncontrolled diabetes or auto-immune disorders. You will also need to have a healthy heart and lungs if you wish to have plastic surgery of any kind. This entails giving up smoking (if you smoke) for at least two weeks before your surgery, being at a healthy weight, and having normal blood pressure.
Having a current medical condition does not necessarily mean that you absolutely cannot have facial fat grafting. However, you will need to work closely with your doctor to manage your condition.
- You will need to have realistic expectations for this procedure. As mentioned above, the results of facial fat transfer vary somewhat from patient to patient. While you are likely to see some change in your face after a fat transfer the results may not be dramatic in nature. If this idea makes you uncomfortable, you should try another treatment approach instead. If, on the other hand, achieving a natural look is extremely important to you, then facial fat transfer is a safe bet. The subtle but attractive changes it creates are perfect for those who hope to avoid looking like they have had “work done.”
Likewise, it’s important to understand that facial fat grafting alone cannot make you look significantly younger if you have other outstanding issues, such as significant skin laxity. Transferring fat to your face will help rejuvenate your appearance, of course, but it probably won’t compensate for issues like loose, hanging neck skin or drooping eyelids. If you are dealing with more advanced signs of aging, then it is strongly recommended that you pair this procedure with a facelift, brow lift, and neck lift. If you do so, then you will be able to take eight to twelve years off your face.
Do I Need to do Anything Special to Prepare for Facial Fat Grafting?
Aside from quitting smoking if you’re a smoker, you will need to take the following steps in order to prepare for your facial fat grafting appointment:
- Do not take any medications unless you have cleared them with your plastic surgeon beforehand. Taking even over the counter medications, like ibuprofen or aspirin, on the day of your surgery can interfere with the procedure. You should therefore avoid taking any medications, vitamins or herbal supplements that have not been expressly cleared beforehand.
- Complete a blood test if you have been asked to do so. Some surgeons require that their patients complete a blood test in order to rule out any health conditions.
- See your doctor for a complete physical. Like having a blood test, this can help you rule out the possibility of any health issues you were not previously aware of.
- Stock up on soft foods. It’s a good idea to have soft foods at the ready in the event that you experience any facial discomfort following your fat transfer.
- Make sure you understand correct recovery protocol. Your surgeon will give you a list of things you should and shouldn’t do while healing from your facial fat transfer—make sure you read it. Some activities, such as wearing cosmetics and massaging the face, should not be engaged in while you’re healing. Remember: Proper after-care is essential to ensuring that the transferred fat cells remain in place.
As long as you understand the potential risks and rewards, facial fat transfer can prove to be an extremely satisfying procedure. Most patients feel that facial fat transfer comes closer to recreating the face of their youth than any other procedure.