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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 (17)

Fat Grafting Results Can be Permanent

+7
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
4.5 out of 5 stars 37 reviews

How long do fat grafting results last?

+4

Don,

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 58 reviews

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With proper injection technique, fat grafting can be permanent

+3

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
5.0 out of 5 stars 6 reviews

Facial fat grafting can last for years

+3

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.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.5 out of 5 stars 32 reviews

Fat grafting can give very good long term results

+3

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 13 reviews

Fat Grafting Longevity- Why and How

+3

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 27 reviews

Duration of fat grafting to cheek

+1

Fat grafting has taken a good deal of the market away from cheek implants. The fat is softer and does not cause local issues like resorption of the cheek bones and nerve injuries that may be encountered with cheek implants. Take is very good in the face. The volume restored with fat mimics the youthful fullness very well.

Michele A. Shermak, MD
Baltimore Plastic Surgeon
5.0 out of 5 stars 26 reviews

How Long Do Fat Grafting Results Last?

+1

Fat grafting is generally permanent once the fat is stabilized in it's grafted area. The fat can continue to go away with the aging process. As for the cheeks, either treatment will work and each has certain characteristics. I prefer fat grafting as it is less invasive and has fewer complications.

Kurtis Martin, MD
Cincinnati Plastic Surgeon
5.0 out of 5 stars 24 reviews

Fat Grafting Results Permanent Improvement

+1

Fat Grafting Results Permanent improvement in most cases. Micro fat grafting, also called structural fat grafting involves multiple injecions of very small amounts  of fat injected in a series of discrete layers to allow for better revascularization and "take", gradually increasing the volume of  new soft tissue. My experience is that it is a great minimally invasive procedure for cheek augmentation.

Fat Cells that survive this transfer process continue to live like other fat cells. Therfore the results are long lasting. The problem is not all transferred fat survives the process. In the face for example it has been estimated that up to 60%  or more will survive in the cheek region. Of most interest is that the fat that does survive behaves as if it was still in the donor site. Therefore as the surrounding native fat tends to atrophy the transferred fat will not. Over time you will notice that the area may not be as full as it once was, but more than likely it is because of the native fat atrophy rather than the transferred fat.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 38 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.