Treatment of facial aging changes with fat grafting must be carefully individualized to match each patient's aesthetic needs and desires. I always examine and assess how each aesthetic area or 'unit' of the face contributes to an individual's overall appearance: the brows and eyelids, the cheeks or 'midface', the lower face and chin, and the neck. An individualized surgical plan is then developed which addresses each patient's specific concerns and needs. Therefore, the price of a facial fat grafting will depend on exactly what each person needs and the time required to perform surgery. To select a plastic surgeon, take your time researching , visiting websites, view many, many before and after photos and speak to former patients.Achieving survival of grafted fat requires appropriate instrumentation, meticulous surgical technique, and a willingness on the part of the surgeon to put a significant amount of time and effort into mastering the procedure. The fat must be harvested in a manner which ensures fat viability, and it must be grafted in a manner that permits revascularization (i.e. blood supply) of the grafted tissue.Areas that already have some soft tissue fullness, such as the cheeks, are relatively easy to expand with grafted fat, as a robust ‘scaffolding’ exists to hold the grafted fat. Thinner areas are more challenging: the temples, the lower lid / cheek junction, the nasal dorsum; these areas frequently require more than one fat grafting procedure to achieve the desired degree of volume enhancement. One can only add but so much fat in a single treatment when the ‘scaffolding’ is limited.There really are no ‘shortcuts’ that a surgeon can take when performing fat grafting surgery. Every step in the process must be performed with great attention to detail. Make sure that the surgeon you choose provides some description of their fat grafting technique, provides some indication of their level of experience with fat grafting, and demonstrates to you a high level of success in terms of fatsurvival and natural-appearing results as represented by ‘before and after’ photography. Beware of doctors who discount their fees. Discounting the value of professional services, especially surgery, is not good marketing - it is a sign of desperation. The best plastic surgeons are still busy in this contracting economy, and they are not discounting their fees. At the same time, the most expensive surgeon is not necessarily the most talented, so as a consumer you still have to research this carefully. There is much more to consider than just the price in dollars that you pay: is your surgeon actually listening to you, do they truly understand the appearance that you hope to achieve, do you feel that he or she will be easily available and attentive once the surgery has been performed. If you don't have a good feeling, don't stick around to 'save money', go somewhere else.