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Is Structura Fat Grafting As Effective As Using Perlane or Radiesse for Under Eyes, Infraorbital Rims,cheeks and Jawline?

For nasolabial folds which filler has the longest duration and is also the most effective Perlane or Radiesse? Does the actual Fractional CO2 Laser used for facial resurfacing make a difference in the healing process, for example is the laser Lumenis Ultra Plus a superior Laser in comparison to other Fractional CO2 Lasers?

Doctor Answers 5

Choosing the right under sys filler and laser intervention

As far as lasers, the only true fractional lasers are the erbium laser based products such as Scitons Erbium profractional.  CO2 lasers cause etoo much coagulative damage to be truly fractional and I would recommend staying way from them.  Structural fat grafting if done correctly is hands down the best filler and lasts the longest.  Radiesse will likely destroy fat in your face, cause granulomas and cause facial aging-stay away!  Perlane Juvederm and other hyaluronic acid based fillers are safe and can provide corrections for about one year.  I hopee this helps!


All the best,


Rian A. Maercks M.D.

Miami Plastic Surgeon
5.0 out of 5 stars 44 reviews

Under eye fillers

It will be interesting to see the varied responses to this question. I feel strongly that fat under the eye can be a nightmare if not done exceptionally well. This is the thinnest skin in the body and minor contour irregularities are clearly obvious. For this reason I prefer the thinner hyaluronic acid fillers such as restylane. Perlane is thick and best used in the nasolabial folds. Hyaluronic acids are also particularly valuable in this area because they can be dissolved if you are unhappy with the appearance. you do not have this luxury with radiesse or fat.
Fractional Co2 lasers today are fantastic but they must be tunable which means your surgeon can set the parameters to customize your treatment to your specific needs. I prefer the DOT laser as this can be a fine no downtime experience or a completely ablative resurfacing. The bottom line is the experience of the provider is more important than the specific device used.

Seek out a board certified plastic surgeon to help you with these decisions. I hope this was helpful.

Robert W. Kessler, MD, FACS
Corona Del Mar Plastic Surgeon
5.0 out of 5 stars 104 reviews

Fat grafting

Fat grafting, in experienced hands can achieve very natural long lasting results, whereas the fillers need to be redone from time to time. The volume created by fat is more natural appearing as well. Special care needs to be taken around the infraorbital rims as the skin in this region is quite thin.

Laser can be done at the same time.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 28 reviews

Fat grafting versus injectable fillers

In my opinion, fat grafting produces better, more natural correction for treatment of under eye hollowing, cheek augmentation and jawline improvement compared to injectable fillers. More volume can be used and the results are long lasting.

For injectable fillers, I prefer Radiesse for the nasolabial folds as it seems to provide more lift and collagen stimulation in the area. But more than the product used, the determining factor is the skill of the physician treating you.

-Dr. Jamil Asaria

Jamil Asaria, MD
Toronto Facial Plastic Surgeon
5.0 out of 5 stars 72 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.