Another fat transfer after 3 years? At 46, I am moving away from fillers. (photos)

It has been our experience that result after fat transfers to areas like nasolabial folds and lips are by far behind results we have with fat grafting in periorbital area, temples, breasts, buttocks, etc.. Very likely it is due to the fact that these areas constantly move and there is no way of proper imobilization. An average take of fat grafts in this areas is around 10-15% and it requires multiple procedures (2-3) to build desired volume. There is no reason not to proceed with fat grafting in your case but it will require patience on your part and excellent skill of your surgeon. Hope this helps.

A will done facial fat transfer should last about 5 years. You will see aging and some fat loss at 3 years so doing another transfer seems reasonable especially in light of the photos you submitted.

Hi Petalo - if you had success with fat grafting before, then I would definitely consider doing it again! Otherwise an alternative could be the more 'permanent' fillers such as sculptra/radiesse, although it sounds like you are not interested in that. I'm not sure what is causing the dimple, you could consider dissolving the filler you had injected to see if that helps. PRP doesn't help with volume so that would not be your best bet.
Unfortunately, aging continues, which is why you are noticing after ~3 years from your fat transfer that you might need some again. Without pursuing a lift to really set your aging back, the fat transfer can only rejuvenate you a little bit before the aging catches up again.

It is not unusual to require additional fat transfer to the face. If it has been 3 years then it has resulted in pretty long lasting results, better than any filler. It is possible that after a 2nd session you will have a more long-lasting result.

You have a thin face, and in my 30 year experience with fat transfer for optimal results most people feel the need to augment every 3 years but the results are natural. You have some skin laxity and some form of midface lift or lower facelift is something you need to consider in the next few years. Volume addition cannot overcome skin laxity unless the volume added is so much that it risks changing your facial shake in an unnatural way.