My approach to fat grafting is not to over-correct. It is dificult to know how much fat will persist. The objective is for the fat to build a blood supply and be permamant. See photos in the link to my fat grafting gallery below.
Overcorrecting can provide an extended recovery period at best, and a permanently distorted appearance for many. In some cases, a follow up fat grafting procedure could be desired.
An unavoidable reality of fat grafting is that the degree of fat survival cannot be completely predicted nor can it be guaranteed. Fat survival will vary somewhat from patient to patient and from procedure to procedure. My impression is that many surgeons ‘manage’ this issue by overdoing it when they perform fat grafting surgeries, assuming that a significant amount of the grafted fat will not survive. This leaves patients vulnerable to an unnatural, over-grafted appearance if fat survival is greater than the surgeon expects.
Excessively full cheek volume is currently seen quite a bit in the media, and it is probably a consequence, at least in part, of the widespread popularity of temporary soft-tissue fillers such as Juvederm and Restylane. Full cheeks are fine, to a point, but if overdone it can produce an extremely odd and unnatural appearance. It appears particularly unnatural on animation, as when the cheek volume increases with a full smile. Look carefully for excessively full cheeks in your surgeon’s ‘before and after’ photos, as the fullness you’ll get from fat grafting surgery is not temporary
My approach is to graft fat to the point that the soft tissue contour is, in my opinion, aesthetically ideal but still quite natural-appearing. This eliminates any concern of an ‘over-grafted’ and unnatural appearance. In my practice we offer secondary fat grafting for areas that I have previously treated at a significantly discounted cost from the initial procedure. That allows patients to go into their surgery with confidence that (1) they will not have unnatural appearance after recovery from surgery and (2) any areas that require additional volume enhancement can be treated at a very reasonable cost. Areas which have thinner soft tissue thickness preoperatively - such as the lower-lid cheek junction - are the areas that are most likely to require secondary (and occasionally tertiary) fat grafting procedures.