Thanks for the question. I have had successful outcomes following laser/IPL/RF treatments using fat transfer (see the video testimonial shot at 11 months. photographs on my site are at 15 minutes following a single session of fat transfer for a patient after supposed IPL injury). Although none of us is clear as to whether fat transfer is effective in every case, but I am confident that it will work well.
Fat grafting works tremendously well to counteract facial volume loss of most kinds and stay safe without lumps or cysts in almost every patient if you are a skilled fat transfer surgeon. I would say the risks that I am more worried about are the following:
1. realistic expectations of what i am trying to achieve. sometimes we look at every nook and cranny needing filling. i don't believe that is possible with fat. fat provides an overall beautiful result (see my photos on my site. link below to fat transfer home page) for the face.
2. if the person is very young say below 30 or so and has not had children, the one thing that i am worried about is future weight gain with metabolic slow down etc. now the good thing is that if i am just treating some early aging, i am conservative with the fat application to begin with so that tends to work well even for future aging.
3. since fat is a live graft, i place the fat relatively symmetrically because it might grow differently if you treat one side with a ton of fat and the other with less. accordingly, i do not use fat to try to correct micro asymmetries or even major asymmetries because of long-term safety.
these are some of my initial thoughts. please look at my website to get a much more detailed understanding. i also have a forum on their dedicated to fat transfer in which i could respond to similar questions.
dr. samuel lam
facial plastic surgeon