Is it true that facial fat grafting can create scar tissue that makes it difficult for a future facelift?

Question

Also is it true that you shouldn’t have multiple fat grafting to face due to creating scar tissue ?

Edwin Kwon, MD, FACS · Answer

It's a fair question, and the short answer is that fat grafting does leave some scarring in the tissue, but in most cases it doesn't stand in the way of a well-planned facelift later. When fat is placed in small amounts through many tiny passes, most of it blends into the surrounding tissue, and what's left behind is a mild amount of internal scarring rather than a thick layer. Much of the fat is placed in deeper layers, and an experienced facelift surgeon can work through areas of mild scarring without much difficulty. Problems are more likely when large volumes are injected in a single session, when fat is placed in clumps, or when the grafts don't survive well, because that's when firmness, lumps, or oil cysts tend to form.

As for repeat sessions, having more than one round isn't automatically a problem, and some patients do better with two moderate treatments than one aggressive one. Spacing them several months apart lets the first round settle so you can see how much fat survived before adding more. How the fat is harvested and processed also matters, since handling it gently helps more of it survive and leaves less behind to scar. If a facelift is something you're likely to consider in the next several years, it's worth planning the two together so the timing and amount of fat make sense for your face. I'd encourage you to schedule a consultation so your anatomy can be evaluated in person and a plan can be built around both your current goals and any future procedures.

Kyle Kimura, MD · Answer

Thank you for your question. I have not seen fat grafting cause issues with facelifts. In general, the fat from grafting (as long as this is your own), integrates well with your surrounding tissues. Compared to some of the artificial filler options or even some collagen stimulating options which create scar tissue, fat grafting is far better for the tissues and minimizes damage that could be problematic for a facelift in the future.

Henry Daniel Sandel IV, MD, FACS · Answer

Facial fat grafting can produce scar tissue, firmness, or lumps, particularly if some of the transferred fat does not survive. However, having fat grafting does not automatically prevent a future facelift or make it significantly more difficult. The effect depends on where the fat was placed, the amount injected, and how the tissues healed. Significant scarring can make later surgery more involved.

My reservations about facial fat grafting relate more to the unpredictability of fat survival, the potential for unevenness or overfilling, and the difficulty of correcting unwanted volume. It can be useful in appropriately selected patients, but I favor a more predictable approach.

There is no blanket rule that you should never have more than one treatment. Some patients benefit from staged grafting, but additional sessions should have a clear purpose and follow an assessment of the healed result. Repeatedly adding volume is not a substitute for addressing tissue sagging.

If you are considering a facelift, discuss that plan before undergoing further fat grafting. A surgeon who performs both procedures can evaluate your existing volume, any areas of firmness, and whether lifting, volume replacement, or a combination would best address your concerns.

Is it true that facial fat grafting can create scar tissue that makes it difficult for a future facelift?

Answers (3)

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