Fat Transfer (Face)

Lost facial volume can be restored through four methods:

• Fat transfer procedure
• Injectable fillers that are either made of hyaluronic acid (HA), a naturally occurring substance, or non-HA substances that act as collagen stimulators
• Implants using solid materials compatible with human tissue
• The repositioning of tissues using surgical methods such as deep plane facelifts, buccal fat pad removal or repositioning, and lower blepharoplasty fat repositioning

Each method has its benefits and limitations. Facial fat transfer, also known as “autologous fat grafting,” is prized for offering a natural and versatile method of restoring volume, which typically leads to subtle and authentic-looking results using your own body’s natural tissues.

This technique involves harvesting your own body fat and meticulously injecting it into specific areas of your face to enhance volume, facial shape and definition. The fat is typically harvested by using liposuction techniques from areas where it tends to be abundant, such as the abdomen, flanks or thighs.

There are different areas of the face where fat can be injected. The face is segmented into upper, middle, and lower thirds, and each exhibits distinct transitions as we age.

In the upper third of the face, there can be atrophy and drooping of the eyebrows and a hollowing of the temple. Fat transfer here can lift and volumize the area three-dimensionally, smoothing the transition from the upper eyelids to the brow and temple; this helps to restore the gentle, natural arch of a youthful appearance.

The middle third of the face, encompassing the lower eyelids and cheeks, is where expressions come to life. Age can create hollows under the eyes and flatten the cheeks. Skillful fat-grafting redefines these areas, softening the tear troughs and restoring cheek volume.

The lower third of the face, which includes smile lines, jawline, lips and chin, holds the foundation of your facial structure. Over time, this area can show deeper lines and a less defined jawline. Fat transfer here smooths the depth of nasolabial folds (smile lines), subtly reshapes the jawline, and revitalizes the lips and chin.

Facial fat transfer utilizes your body’s own natural tissues, which makes it an appealing choice for those interested in subtlety above all else.

Although minimally invasive, it is important to note that this procedure is still a surgery that carries risks, requires planning and necessitates recovery time. It’s also important to understand that not all transferred fat survives. The volume enhancement that persists, however, is considered semi-permanent, with many studies reporting long-lasting effects.

Facial fillers and collagen stimulators such as hyaluronic acid (Restylane®, RHA®, Juvéderm®) poly-L-lactic acid (Sculptra®) and calcium hydroxylapatite (Radiesse®) are alternative options to fat-grafting that can be used in relatively simple “lunchtime” procedures.

Although fillers can also offer relatively long-lasting results without the need for surgery, many aesthetic specialists favor fat-grafting because it provides more enduring outcomes and the ability to naturally integrate materials with facial tissues, enhancing the overall appearance with a more seamless look.

Common complications from facial fat transfer and filler procedures typically include issues like asymmetry, contour changes, and bruising. Unsatisfactory results can stem from a lack of clear communication between you and your doctor regarding the limitations of these treatments.

The importance of selecting an experienced practitioner with a comprehensive understanding of facial anatomy is paramount. In addition to looking excessive or unnatural if improperly placed, both fat-grafting and fillers carry the risk of more serious complications, such as tissue necrosis or blindness, if accidentally injected into blood vessels.

Fat transfer procedures should exclusively be performed by board-certified surgeons in the specialties of plastic surgery, facial plastic surgery, and oculoplastic surgery. This is a surgical intervention that requires advanced training, precise technique, and a comprehensive understanding of human anatomy that only skilled surgeons with extensive experience possess.

Before you go

Before surgery, you and your physician should have a conversation about your goals and desired outcomes. Together, you’ll review your medical history and any additional tests needed. You’ll be provided with an opportunity to learn more about the surgery, its advantages, potential risks, strategies for pain management, available alternatives, and a comprehensive overview of what to anticipate both during and after the procedure.

You should feel comfortable that all of your questions have been answered and you should never feel pressure to commit to treatments you don’t fully understand. This is particularly important when it comes to fat grafting since the effects are semi-permanent and not easily reversible.

During the procedure

Facial fat transfer typically involves minimal discomfort and is often done under local anesthesia, with or without IV sedation, depending on your and your surgeon’s preference. If the fat transfer is performed in combination with blepharoplasty and facelift, you may require general anesthesia.

The surgery typically involves harvesting your own body fat from the abdomen, flanks or thighs using liposuction techniques. Only small amounts of fat are harvested, making minimal changes to the donor area’s physical appearance. Several methods exist to process and purify the fat before it is meticulously injected into specific areas of your face to enhance volume, facial shape and definition.

Fat Transfer (Face) Aftercare 

Post-procedure care is key, especially when fat transfer is combined with other procedures such as an eyelid lift (blepharoplasty) or facelift. Avoid touching or applying pressure to the treated areas for at least a week to prevent displacing the newly transferred fat.

Rest is crucial during the postoperative period, and you should plan for a few days of downtime to allow your body to heal. However, ensure you walk and move around several times a day to prevent complications such as blood clots.

Mild swelling or bruising is normal; your doctor will advise on how to minimize these effects and speed up recovery. You may experience some discomfort, which can be managed with over-the-counter medication like acetaminophen (Tylenol) or a pain medicine prescribed by your surgeon. Avoid ibuprofen and similar anti-inflammatory drugs for the first two weeks, as they may increase the risk of bleeding and bruising.

You can expect to return to routine activity after one to two weeks. Most surgeons permit a return to full exercise at three to four weeks, but you should confirm this with your doctor. Note that it may take several months for the final results of the procedure to take effect.