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How Long Do Fat Grafting Results Last?

I am trying to determine whether micro fat grafting is a better option for cheek augmentation than implants. I was researching it today and saw that some final results look great, better than any of the cheek augmentation photos I've seen. But I'm still apprehensive about taking this route. How long do micro fat grafting results usually last?

Doctor Answers 29

Fat Grafting Results Can be Permanent

Fat grafting has been performed by plastic surgeons for decades. There is no question that fat is the ideal material for soft tissue augmentation, and that the results obtained with fat grafting are the most natural-appearing. However, one problem with this procedure in years past has been resorption (breakdown) of the grafted fat, so that the resulting improvement is not permanent. The grafted fat must gain its own blood supply in its new location in order to persist long-term, and this generally is not possible when large amounts are injected at once and when specialized instrumentation and techniques are not employed.
A relatively new technique has been developed called structural fat grafting, in which small amounts (less than 0.1 cc at a time) of fat are carefully microinjected in a series of discrete layers to gradually 'build' new soft tissue structure. As there is space between each microinjection, new blood vessels are able to grow into the grafted fat, allowing it to persist. If this process of blood vessel ingrowth (neovascularization) does not occur, then the injected tissue cannot truly be considered a 'graft' and is instead just another 'soft tissue filler' of limited duration.
Fat Grafting requires specialized training and specialized surgical instruments, as well as patience and attention to detail on the part of the surgeon. When performed properly, permanent improvements facial plastic surgery are possible.

Raleigh-Durham Plastic Surgeon
5.0 out of 5 stars 70 reviews

Fat Grafting Longevity- Why and How

The longevity of fat transfer will depend on 3 main factors that basically b:

1) Technique- Fat grafting is a technique sensitive procedure, meaning that fat survival will vary from surgeon to surgeon depending on how they perform this. Technique boils down to: 1) How the fat is removed / harvested 2) How the fat is processed / distilled and 3) How the fat is injected. 

2) Where the fat is injected. Fat is very reliable in some areas while not being as reliable in others. The reason being is that fat is a live tissue graft. Once the fat is injected it needs to grow a new blood supply and get nourishment from the body. If this process occurs, then the fat will take permanently.  Areas of the face that move more, such as the lips, have lower reliability and take of fat. This is because that area is constantly mobile and the fat will have more shearing forces that prevent it from obtaining the new supply.  On the other hand, fat in the cheeks and temples has a much higher rate of take because it is much more of a static area.

Bottom line is that facial fat grafting is very technique sensitive and it is very important to choose a surgeon with experience and first hand knowledge of the procedure. Always ask to see photos, especially of patients over a year out of the procedure.  This will help you understand your surgeon's experience and results.

See the link below for more explanation and a patient that is over a year after fat grafting to her face.

Jacob D. Steiger, MD
Boca Raton Facial Plastic Surgeon
5.0 out of 5 stars 35 reviews

How long do fat grafting results last?


In answer to your questions
1. "How long do fat grafting results last?" - If the fat survives the transfer it is like every other living tissue in the body. It lives almost as long as you do EXCEPT that if you lose weight they deflate and if you gain weight, it will fill up.

2. "trying to determine whether micro fat grafting is a better option for cheek augmentation than implants" - If the fat lives, it is a far better option because it does not share the potential complications of implants : immediate or late infection, movement, encapsulation, distortion and extrusion.

I hope this was helpful.

Peter a Aldea, MD, FACS

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 83 reviews

With proper injection technique, fat grafting can be permanent

Results can vary, depending upon several factors such as what area is being grafted and how it is placed. Fat grafting is a highly skilled procedure, requiring a surgeon with experience and knowledge to perform it successfully. The survival of the fat will depend upon those skills and will be the result of how the fat was harvested, how it was purified, and how and where it was injected. Specifically, a process called ‘micro fat grafting’, though labor intensive, is the best way to ensure that the highest percentage of grafted fat will take.

When done successfully, the injected fat grows a new blood supply and begins to receive the nourishment it needs to survive from your body. When this happens, results can and often are permanent. However there can be a percentage of fat that does not take and this is why touch-ups are sometimes necessary. It is important to discuss options in advance to determine the best course of action for your situation.

Scott W. Mosser, MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 9 reviews

Fat grafting can give very good long term results

Patients often ask how long fat grafts last. While very surgical technique dependent very long term results are certainly possible. Once the grafts take hold and "blossom" over the first 12-18 months the results should be evident for many years. Not even the fat that is naturally in your face lasts a lifetime -- we all lose it slowly over years. However, by refilling the volume loss with fat grafts you should always see an improvement compared with if you didn't have the procedure.

I find that for most people fat grafting provides a more natural result than cheek implantation. 

  • Fat grafting allows for more intricate customization of which portions of the cheek to augment (and how much).
  • Fat grafting isn't limited anatomically by the infraorbital nerve (a sensory nerve that exits the bone just below your eye). A cheek implant can't be placed above this nerve limiting how high one can provide augmentation.
  • With a cheek implant, as the soft tissues of the cheek continue to lose bulk/fat with time the implant can become even less natural appearing.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

Facial fat grafting can last for years

With proper fat harvest and grafting techniques, fat injection to the mid-face and cheeks can result in volumization that can last for years. Regions of the face with motion (lips, nasal-labial folds etc) tend to not hold on to fat as long as the mid-face and cheek regions of the face. These regions are more static.

Fat grafting longevity

The length of time that fat grafts last has quite a bit of variability between both the surgeon and the patient. Newer techniques using microagumentation and smaller size injections seems to help promote better fat survival. It tends to last the longest in the cheek areas and midface and less long in the nasolabial or smile regions. The temple areas are variable and the eyelid regions seem to persist. I hope this information helps.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

How long do fat grafts last

70% of plastic surgeons are doing some kind of fat grafting as part of a facial rejuvenation. The concept of lifting the sagging skin of the neck and jawline and outer cheek and restoring the volume to the eyes and the central face is more often the norm. Fat grafting not only creates volume but improves skin quality. Duration of result may be permanent for grafts that take. Generally at least two treatments are required. You can see see the result of each treatment at about 4 month. Make sure that you consult with a Plastic Surgeon certified by the American Board of Plastic Surgery who is also a member of the American Society for Aesthetic Plastic Surgery and has experience in fat grafting.

Fat grafting for cheeks

Dear Longevity,
Fat grafting has become the "go to" technique for augmentation in cheeks, buttock, lips, etc.  Newer techniques in fat preparation have made the fat 98% viable and stay long term without absorption.  The important issue is that it is your own tissue, it vascularizes and lives where you put it and there is less risk of infection over time as a result of this.  So it is safe and lasts as long as you maintain your weight.  It does change in volume if you lose or gain a ton of weight.  So stay steady in your weight after the procedure.

Semira Bayati, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 27 reviews

How Long Do Fat Grafting Results Last?

The decision for fat grafting vs implants of the face depends significantly, I believe, on the shape of the boney structure supporting the overlying soft tissues.  If the boney support is very poor (for example, very flat or depressed cheek bones), then a cheek implant will provide the necessary foundation to support the overlying soft tissues.  If the boney support appears adequate, but the soft tissues are insufficient (as in the case of fat atrophy from aging or disease), then fat grafting is a very good solution to soft tissue restoration or augmentation.  If the fat grafting is performed skillfully and with gentle fat harvesting and fat injecting technique, then a high rate of permanent "take" can be expected throughout most of the face.  The exception are the lips, which tend to have a lower take of fat grafts.

Paul Fortes, MD
Houston Plastic Surgeon
4.0 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.