Fat Grafting (Fat Transfer) to the Face

Fat Grafting to the Face

Many patients I see looking for a rejuvenative touch, ask me what the best filler for different areas of the face is. Without a doubt, it is fat. There are many reasons for this. It is voluminous, able to be harvested painlessly from the tummy or medial thigh in sufficient quantities to volumize the entire face. It is natural; your body won’t reject it and unless injected carelessly, will result in a smooth rejuvenation even in hard to correct areas like eyelids and tear troughs. Finally, it has stem cells. Yes, fat derived stem cells are injected with these grafts. It is still controversial whether these stem cells do in fact repair overlying scars after fat injection or have other beneficial effects on the skin. Nonetheless, there is anecdotal evidence of significant improvement in scar maturation and in skin health after fat grafting.

In younger individuals interested in a rejuvenative touch, fat grafting adds volume to areas that frequently see the earliest signs of atrophy, like nasolabial folds, lips, and cheeks. In older individuals that would benefit from a facelift procedure, fat grafting is frequently added to the procedure to restore volume that improves fine lines that are not addressed with the facelift technique. In fact, the combination of a facelift with fat grafting has become the gold standard in facial rejuvenation.

Now fat grafting does not come entirely without some drawbacks. There is a donor site to consider which requires some small anesthesia to allow for harvesting and some recovery. However, the small volumes required for fat grafting to the face, in the order of 40-60 cc, do not result in significant changes to the donor. There is also swelling and bruising that can result from injecting the fat. This is probably the biggest drawback. If bruising occurs, it can take 2-3 weeks to completely resolve. The careful use of local anesthetics and anti-bruising oral homeopathic agents can help limit this.

A recent article by Dr. Rohrich, et al, in the Plastic and Reconstructive Surgery Journal summarizes the varied ways fat can be used today to rejuvenate the face, including the forehead, and the chin in place of a chin implant. The article is free and can give you an idea of what to expect from the procedure. You can find it in the following link:

Preoperative and postoperative results after rhytidectomy and blepharoplasty with facial fat augmentation.
Xue, Amy S. M.D.; Dayan, Erez M.D.; Rohrich, Rod J. M.D. Facial Fat Augmentation Finesse, Plastic and Reconstructive Surgery: October 2020 – Volume 146 – Issue 4 – p 416e-419e
doi: 10.1097/PRS.0000000000007205

Visit us at Thomassen Plastic Surgery to learn more on how fat grafting can be used in facial rejuvenation.

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