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Does Analogous Fat Transfer Lead to Sagging Facial Skin?

Once the injected fat dissipates, will the skin then sag? It stands to reason that delicate facial skin can remain stretched out after the injections are reabsorbed. Typically, what percentage of the transferred fat will remain permanently?

Asked 38 months ago by NoPlasticFlower in New York

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Fat injections and facial skin sagging

This is the big question, how much fat survives. My theory has been that no more fat can survive than you start out with initially. Our studies have shown that 75+% of fat injections are dead. Other metabolic studies show up to 96% of injected fat is dead. People talk about stem cells somehow creating new fat, but the number of stem cells is minimal in normal fat injection specimens. I am told by my colleagues at UCLA who have published in this area that in order to harvest stem cells... more

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Brent Moelleken, MD

Beverly Hills Plastic Surgeon

ASAPS ASPS

Fat transfer is one filler that can produce long term results

The facial skin would fall back to its origin prior to the fat transfer or be better than before. When liposuction is done on the neck underneath the chin, the skin actually retracts via collagen formation and contraction. The skin seems to get sucked back and up, rather than falling. Fat transfer is a graft. Some fat cells actually live so don’t imagine that all will be digested, but the cells that do go away don’t leave an empty cavity that allows the skin to fall away. The... more

Ronald Shelton, MD

Manhattan Dermatologist

Facial skin will not sag with fat grafting

With fat grafting, blood vessels from the injection site and blood vessels in the fat must re-establish blood flow via arteries and veins to survive and “take”. When this happens, final results can be permanent. However if you’re looking for a temporary solution, you may want to consider dermal fillers, as the results of fat grafting can be difficult to predict. Regardless of the option chosen, the face does not swell enough from the procedure to permanently... more

Scott W. Mosser, MD

San Francisco Plastic Surgeon

ASAPS ASPS

Fat Transfer takes a step forward

Fat transfer is more than volume replacement. Fat Transfer also brings stems cells that rejuvenate the skin. The key to good fat transfer is 1- lots of live cells at the time of injection. Viafill system is much better than the alternatives. 2- Good technique with small pearls of fat that get better blood supply and eliminate the lumpiness. Viafill is great for this as well.

Robert M. Freund, MD

New York Plastic Surgeon

ASPS

Fat grafting and the deflated beachball of age

Since fat grafting adds volume, it does not create saggy skin. Rather the opposite is true, it adds volume and 'inflates' the saggy skin. We often remark that the aging face is like a deflated beach ball, but the youthful face is full and round like an inflated beach ball. Essentially, the fat transfer procedure harvests fat from one part of the body where an excess exists and then places it in another part of the body where the additional bulk is used for cosmetic and aesthetic purposes.... more

Ross A. Clevens, MD

Melbourne Facial Plastic Surgeon

Unlikely for fat transfer to cause sagging skin to get worse

It is unlikely that a fat transfer will cause the skin in that area to sag later in life. The skin will sag due to the effects of gravity and aging, not due to the volume restoration that you can achieve with fat transfer. You may require more than one session of fat transfer as a certain percentage of the fat cells will not survive. That percentage depends on the technique and can be as high as 50% not survivng in some studies. Especially in the face, with its robust blood supply, the... more

William Bruno, MD

Beverly Hills Plastic Surgeon

ASAPS ASPS

Fat transfer survival

Dear NoPlasticFlower, The amount of take on a fat graft procedure varies widely. There are certain techniques that lead to higher yields, as well as patient factors. The acceptance of fat as normal tissue can range from 20-75% depending on the patient and technique. You are best to go to an experienced fat transfer surgeon for more accurate results and photos. As far as sagging, this doesnt happen. It is almost like blowing up a balloon that is partially... more

Nima Shemirani, MD

Beverly Hills Facial Plastic Surgeon

Skin response to facial fat grafting

There is just not enough facial volume augmentation to result in skin stretching if and when the fat graft resorbs.

Scott Sattler, MD

Bellevue Plastic Surgeon

ASPS

Fat transfer should not lead to sagging skin

While not all of the injected fat survives during a fat transfer procedure, the facial skin doesn't become overstretched and lead to more sagging. If the procedure is performed well, the skin should appear less saggy do the replaced volume. It's hard to comment on how how much fat survives during a transfer procedure. Gentle handling of the fat grafts during the procedure helps to ensure maximal survival. Also, careful 3-dimensional placement within the facial soft... more

Thomas A Lamperti, MD

Seattle Facial Plastic Surgeon

Sagging skin after fat transfer

There is a lot of post operative swelling after fat transfer but I have not seen any increase in facial sagging. The fat seems to have the opposite effect of improving the tone of the overlying skin. This assumes, that the transfer is done properly so that the fat tissue that is transfered survives. Lisa Lynn Sowder, M.D.

Lisa L. Sowder, MD

Seattle Plastic Surgeon

ASAPS ASPS

Fat transfer for sagging facial skin

Fat transfer to face is an extremely effective and powerful technique. In our practice, we are using fat transfer in the majority of our facelift patients. This is because ask patients age, they will have to significant physiological effects. They will lose elasticity of the skin and they will also lose volume interface. Fat transfers can help with both effects. Fat transfer will increase the volume and create a fuller and more youthful contour of the face and can also improve the... more

B. Pat Pazmino, MD

Miami Plastic Surgeon

ASAPS ASPS

Sagging skin after fat grafting not a concern

Your concern is that the initial swelling form the fat injection will stretch the skin and as some fat resorbs that it will cause sagginess. This is not true since the amount and duration of swelling from the fat (even with planned overcorrection) is not enough to stretch the skin.

Doctor's Website

Sam Naficy, MD

Seattle Facial Plastic Surgeon

Fat transfer and sagging skin

When fat transfer is performed, about 60-70% of the fat will stay as a permanent filler in most spots on the face. However, because of this slight loss, touch-ups will more than likely be necessary.

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Fat Transfer does not cause saggy skin

Fat transfer to the face does not cause sagging of the skin. To the contrary, filling the face with fat causes the skin to drape better and decrease some of the excess skin which is a sign of aging. Though no microscopic studies are available with fat, microscopic studies of dermal fillers such as Restylane and Juvederm show that in areas where the filler is injected, there is increased collagen, likely from stretching of the skin. As to how much fat will take - that is a good question and... more

D.J. Verret, MD

Dallas Facial Plastic Surgeon

Does Fat Transfer Cause Sagging of the Skin?

Hi Kung Fugeisha, I have had excellent long term experience with fat transfer. The reason for these results are three fold. First, meticulously placed micro-fat grafts can have up to a 40-60% survival in terms of the volume placed. Secondly, the process of passing the micro-cannula back and forth repeatedly causes some fibrosis and increased tightening of the skin as it heals in micro-adhesions. Lastly, it has been postulated that there are stem cell like effects on the overlying skin... more

Michael A. Persky, MD

Los Angeles Facial Plastic Surgeon

A complex question regarding fat injections

The only reason to use fat injections is in the hope that they will "take" and be permanent. If you are anticipating a temporary correction, you might as well use Restylane, Radiesse or some other temporary filler in a syringe. In order for the fat to "take", blood vessels from the bed into which it is injected must attach to blood vessels in the fat and re-establish arterial and venous blood flow requisite for survival. Fat that doesn't take is removed by the body in three months or can... more