How Much Fat Needs to Be Extracted to Fill Cheeks and Wrinkes on Face?

     I have done fat transfers on women with less than 10% body fat, and this does not pose a challenge at all.  Volumes range from about 10 cc to 60 cc in most cases.  Find a plastic surgeon with ELITE credentials who performs hundreds of fat grafting procedures each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Fat transfer is used to replace volume in certain areas of the face.  The cheeks are a great site for fat transfer because by replacing fat to this area a more youthful appearance can be restored.  Fat can serve to fill in the depressions and “valley’s” in the face, for instance, underneath the eyes.  It does not helpful with the fine lines of the forehead however.  The amount of fat needed depends on the amount of areas to be transferred to the face.  If you are a very thin person multiple sites may be needed from where the fat is to be extracted.

The answer depends on how hollow the face is.  It can range from a few cc to over 50 cc.  Almost everybody has enough fat for the procedure unless very thin person. In those cases, synthetic fillers are another option.

Your question regarding how much fat is needed to fill the cheeks and forehead lines is tricky.  First, everyone requires a different quantity depending on how deflated they are. Further, every surgeon harvests the fat differently so their yield of fat survival is different. Hence, how much they need to inject is going to vary.  More importantly, facial fat transfer is a very difficult procedure to perform and considering it is permanent, you will want to make sure your surgeon is experienced (performing several cases per week) and that they get excellent results consistently (see lots of before and after photos).  In our practice, it is rare to only inject the cheeks.  This can leave you looking imbalanced, so be aware of this.  Typically, a full face fat transfer is a better option in order to re-fill all the different parts of the face.  Finally, the lines along the forehead are usually treated with botox not fat transfer. 

Dear Michele Andover,


It takes as much as it needs to get the results you are looking for

Typically, I transfer anywhere from 30-60cc (1-2 ounces) of purified fat to a face


Best regards,

Nima Shemirani
 

Fortunately only 25-45 ml of fat is typically needed for the face.  This can be easily obtained in even the thinnest patients so almost everyone is a candidate. I would caution you against fat transfer to the forehead, it does not do well in that location. Botox or Dysport is a much better option for forehead lines. All the best!

Hi Michelle,

I am not sure if you have been advised that you need fat injected into your forehead. This would be an unusual procedure for that problem, so you need to take care here about the advice you may have been given. It would be much more common to use Botox to soften lines in this region.

Fat injections to your cheeks is much more common and is generally quite safe and reliable depending your requirements and your goals. The amount of fat needed is small and we can always find enough fat somewhere on your body!!!

Although not all of a fat graft will survive, the fat that does survive is permanent. I am not sure if you have tried Hyaluronic acid fillers, but they are also an option you should consider. It would avoid an anaesthetic as well as having no donor site. Although they are not permanent, it does last quite some time particularly when used in the cheeks, as it is not broken down as quickly in the deeper tissues. Also it is completely reversible. I would certainly advice starting this way. If you like the look but after 2 years it seems to have gone away, then you could look at fat grafting and at least know you would be happy.

Best wishes

Richard Bloom

Hi Michelle,

As you can see from the great answers you've gotten here there is no exact amount of fat that each patient gets. In fact, even 2 patients with similar anatomy and goals may need different amounts of fat to get the same results.

To start with make sure to discuss with a surgeon about using fat to fill forehead wrinkles - may not be the best way to go for that problem!

Unfortunately we all have fat somewhere - belly, thighs, arms. The thinner a person the less fat they will most likely need for their goals.

As surgeons we rely on our personal experiences with fat grafting, books and papers written on the subject and lectures given at professional meetings to formulate amounts that we feel can best meet your needs.

From a cost perspective we as surgeons want to make sure we get enough fat for your needs the first time around. Unfortunately this isn't always the case and secondary harvesting may be needed to get more fat - a necessary but frustrating occurrence for patients and surgeons alike.

Have an experienced surgeon examine you and go over the procedure for your specific case.  If you decide to proceed then remember that fat grafting is essentially a transplant procedure involving living tissues and there is always some degree of unpredictably in results, amount of fat needed and duration of fat grafting results. If anyone tells you differently be wary as they are not being honest with you.

Facial fat grafting is a great option for patients seeking volume and contouring changes. Just be aware it is a bit of a "buzzword" in plastic surgery these days (kind of like lasers were 10-15 years ago). As a result, a lot of heavy marketing is going on so take it all with a grain of salt, seek out numerous consultations and go with experienced surgeons.

Good luck to you!

Dr . Kamran Jafri

A picture in this case would be helpful. In general, the cheeks do not require much fat to provide good volume for a youthful looking face. I have never used more than 30cc for both cheeks (2 tablespoons) and in most women this can easily be harvested from the belly or inner thigh. Wrinkes on the forehead, however, should be treated with a neurotoxin and/or filler, and possibly even forehead lift depending on your age, your anatomy, and your expectations.

One of the great procedures in plastic surgery is fat transfer or grafting to the face.  The take is now excellent with newer techniques.  The good news is you do not need much fat.  I have done many facial fat procedures and  the volume of fat I have used ranges from 10 cc or less to rarely over 100cc and the maximum ever was 117cc.  The 117 cc was used on a patient who had cancer surgery of the neck and face followed by radiation.  He had severe deformity and did fine with fat transfer leading to excellent improvement.    So to answer your question,  you do not need to harvest much fat.  I prefer to harvest and then centrifuge your fat.  The lower portion of the fat layer then contains the greater density of stem cells which is what we are after.  So if you have 150 cc of fat or so to donate, you will be just fine.  I have had patients who don't have much fat and have body fat %s in the 10 - 11 - 12 range.  It can be a challenge but we have always found enough fat because not much is needed even in very gaunt patients.  So see a surgeon (FACS and ABPS credentials) (this is real surgery) and discuss your interests.  Likely you will have some fat to donate in the flanks and low back areas or medial thighs and in mid tummy.   See three surgeons.  I think you will be pleased.  My Best,  Dr C