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?
How Long Do Fat Grafting Results Last?
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Fat Grafting Results Can be Permanent
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.
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.
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
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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.
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.
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.
Natural fullness with fat grafts
Final results of facial fat transfer
This includes skin grafting, cartilage grafting and bone grafting.
When fat grafting is performed, it is understood by the treating physician that a certain percentage of the fat will be lost and a certain percentage will have a permanent take, giving permanent results.
It is reasonable to expect results to be finalized around six months after the procedure.
At that point, results can be considered permanent.
Since the tissue grafted is fat, it will behave as such.
This means if people gain or lose weight, the grafted fat will respond accordingly.
The percentage of fat that survives or has a permanent take is variable and continues to be of scientific debate.
Fat survival after fat grafting depends on the technique, operator and patient.
It also varies greatly with what areas are treated and how much fat is transferred in any single session.
It is of paramount importance to only have this procedure done by someone properly trained, experienced and talented.
I suggest you have an in-person consultation with an experienced board-certified plastic surgeon who specializes in this type of treatment.
Best of luck,
Mats Hagstrom, M.D.