Fat injections are excellent treatments. But so are dermal fillers. The question is: "what you are trying to treat?" If you have a crease or wrinkle engrained in the skin, you may need a filler placed in the skin to treat this. Fat is not placed in the skin layers itself, but it is placed under the skin in multiple layers.
To treat an area like the nasolabial folds, if you have a sharp crease, you may be better off with a temporary dermal filler like Restylane, Juvederm, Perlane, or Radiesse. I like using the only permanent FDA approved injectable filler, Artefill. Unlike some of the other temporary dermal fillers, results continue to improve with time. Unfortunately, Artes Medical (the company that owns the rights to Artefill) folded a few weeks ago. It had nothing to do with the quality of Artefill, and it is very likely that another company will purchase this technology and it will be back on the market soon.
I think fat transfer works great in broad areas of depression or atrophy, and to try to lift the cheek to reduce the heaviness on the nasolabial fold. It is your own material and there is no risk of rejection. I use it in the temples, tear troughs, infraorbital rims, brows, cheeks, and jawline. I tell all my patients that in my hands, 30-40% of the fat I inject stays for 2-5 years, and the other 60-70% is resorbed by the body within about one month postop. So it will likely need to be repeated, but fortunately, most people have enough to give.
