Hi,
thanks for the question. i do a fat transfer about every other day and have written 2 books on the subject. i know a ton of surgeons do fat for marionette lines but they fail consistently in my opinion. fat is intended to cover bone and soften facial transitions so that people look a ton better but fat is too soft to augment lines with any certainty of a durable result. i know my answer goes against the grain but i truly believe that fat is not the best option for those lines. plus if you overfill those lines, you can have a bulgy result. fat actually is a real graft and can grow and shape over time. that is why when i do fat, i blend it into all the facial zones that require it so that the long-term result is safe.
here is a video on the subject that i just gave 2 weeks ago in San Diego at the annual American Academy of Facial Plastic Surgery. I gave 2 lectures on fat transfer and was course director for a fat course there too.
best,
sml
