Fat injections or filler - which procedure is best for me and how much will I need? (photos)

Question

Over the past two years I have lost 70 lbs. m face is sunk in and I'd like to know how much filler you think is needed and our opinion would fat injections vs filler

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. Based on your concerns, I recommend treatments with Sculptra! This treatment is used to restore facial volume lost due to aging or weight loss by stimulating collagen production. Unlike hyaluronic acid fillers that provide immediate results, Sculptra works gradually over several months to produce natural-looking results that can last up to two years. It's commonly used to treat deep facial wrinkles, folds, and hollow areas, offering a subtle and long-lasting improvement in facial contour and appearance. I hope this helps and best of luck!

I hope this helps and best of luck!

I hope this helps and best of luck!

Nelson Lee Novick, MD · Answer

A full, front-face photo and a profile view with the face at rest would allow for a proper evaluation of filler needs. 
However, the answer to fillers vs. fat injection is rather easy. Of course the hype over fat injections include such claims as fat injections give long-lasting to permanent results because its your own fat; all the transplanted fat survives; etc. 
Well, the reality is that, besides quite expensive, it involvies a two step, minimally invasive procedures, whereby large cannulas are used to harvest fat from the belly, hips, or buttocks, and using a relatively large bore cannula to reinject it into the face (which typically results in quite a bit of post treatment swelling, bruising and tenderness), much of the transplanted fat, separated from its original blood supply, does not survive the transfer. What's more, the fat that does survive retains the characteristics of the location from which it was taken--meaning that when the belly fat develops a midriff bulge with the passage of time, so can the belly fat transferred to the face. Finally, should there be complications of any kind down the line, we do not have easy methods for dealing with these problems. 
Now, contract that with the use of robust HA fillers. Treatments tend to be less expensive. They are a one-step procedures, where the filler is taken off the shelf and immediately injected, with need for additional wounds and healing elsewhere on the body. Bruising and swelling tend to be much less, since the injection process tends to less aggressive, the results are typically immediate. Depending upon the particular HA filler chosen and the location of injections, the results may last up to 1.5 years. And, if there are any adverse or unwanted results, the use of a simple enzyme, hyaluronidase, can dissolve the filler. 
I hope this clarifies why I stopped performing fat injections many years ago, when the more robust HA fillers came on the scene. 
You would be wise to make sure to consult with an experienced, board certified cosmetic dermatologist filler expert and best of luck.

Anna Chacon, MD, FAAD · Answer

Congratulations on your weight loss! Deciding between fat injections and dermal fillers for facial volume restoration depends on several factors, including your desired results, the areas you want to treat, and your overall health. Here’s a comparison to help you decide:

Fat Injections (Fat Grafting)

Pros:
1. Natural Substance: Uses your own fat, which may be less likely to cause an allergic reaction.
2. Long-lasting Results: Fat grafting can provide longer-lasting results compared to some fillers.
3. Dual Benefit: The procedure involves liposuction, which can contour other areas of your body.
4. Improved Skin Quality: Some evidence suggests that fat grafting can improve skin quality due to the presence of stem cells in the fat.

Cons:
1. Surgical Procedure: Requires liposuction and injection, which is more invasive than fillers.
2. Downtime: Longer recovery time compared to fillers.
3. Variable Results: Not all transferred fat survives, so the results can be unpredictable.
4. Cost: Typically more expensive due to the surgical nature of the procedure.

Dermal Fillers
Pros:
1. Minimally Invasive: Quick, in-office procedure with minimal downtime.
2. Immediate Results: You can see the results immediately after the treatment.
3. Adjustability: Easier to control and adjust the amount of volume added.
4. Variety: Different types of fillers are available for different needs (e.g., hyaluronic acid fillers, calcium hydroxylapatite fillers).

Cons:
1. Temporary Results: Most fillers are temporary and need to be repeated every 6-18 months.
2. Allergic Reactions: Although rare, there is a small risk of allergic reactions or adverse reactions.
3. Cost Over Time: While the initial cost may be lower, the need for repeat treatments can add up.

How Much Filler You Might Need
The amount of filler required depends on the extent of volume loss and the specific areas to be treated. Here’s a rough guide:
- **Mild Volume Loss:** 1-2 syringes (1-2 ml)
- **Moderate Volume Loss:** 3-5 syringes (3-5 ml)
- **Severe Volume Loss:** 6-8+ syringes (6-8+ ml)

Ultimately, the best way to determine which procedure is right for you and how much filler you might need is to have a consultation with a board-certified plastic surgeon or dermatologist. They can assess your specific situation, discuss your goals, and recommend the most appropriate treatment plan.

### Factors to Consider

- **Overall Health:** Make sure you are in good health to undergo any procedure.
- **Desired Outcome:** Consider whether you prefer a permanent solution or are okay with periodic treatments.
- **Budget:** Consider the cost of the initial treatment and any maintenance treatments needed.

### Conclusion

Both fat injections and dermal fillers can be effective for restoring facial volume after significant weight loss. Each method has its advantages and disadvantages, and the best choice depends on your individual needs and preferences. A professional consultation will provide you with a personalized recommendation and treatment plan.

Camille Cash, MD · Answer

Congratulations on your impressive weight loss!  There are a few options for you to consider depending on your goals and budget.  Fillers give a quick result with no downtime.  They last one to two years and are very adjustable, meaning if you want a little more you can always return for a touch up.  Another option is Sculptra.  This is a type of filler that helps rebuild your collagen matrix and gives a longer lasting result.  I will include a video on Sculptra that I hope you find helpful.  Yet another option is Renuva.  This is a filler that works differently and is specifically geared to address your concern.  It gradually replaces fat loss with your body's own fat.  You can learn more by visiting my website or a provider near you.

Darryl J. Blinski, MD · Answer

Based on your two posted photos, there is none only Lexi of facial tissue and structure from aging and weight loss that can most corrected by a combination with a mini face neck Lyft with muscle tightening, fat crafting of approximately 30 to 50 cc of nano and micro fat expect me to range from $12,000-$25,000. Best of virtual consult with. The amount of H Fillers needed to show minimal plumbing would be at least, five syringes per side or a total of 10 or more. This is only temporary since filler is metabolize fat grafting is more permanent. Again, best of virtual

Leonard Grossman, MD · Answer

I don’t think anyone can give you an educated guess on your condition because you’re smiling in your photographs. You need to be either evaluated in person by a plastic surgeon or at least submit a good set of photographs where one can see your face in repose, with the views from the front, obliquely and from the side. I hope this helps and good luck from Leonard Grossman MD organic Plastic Surgery.

Jacquelline Leva, DO · Answer

Depends on your metabolism, also medical conditions like hyperthyroidism can make fat Grafting difficult to maintain...if you are a current smoker fat Grafting tends to not do as well. If you are otherwise healthy then yes would be a great candidate for fat Grafting to the face just bear mind it can last people as little as 2 months and others can last for years if you maintain your weight. Dermal Fillers you may need more dermal filler to get the result but in my experience overall health also has an effect on how long filler lasts...both can offer very nice results. Fat may be more economic because they can treat more areas for the same price.

Fat injections or filler - which procedure is best for me and how much will I need? (photos)

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