Which facial fat transfer technique leads to a better outcome?

When it comes to facial fat grafting, as long as your surgeon adheres to a few general principles, then the result will be dependent on her/his aesthetic eye. The fat must be aspirated under low suction and filtered in an atraumatic fashion as to retain their viability. It must be filtered to ensure uniformity of the fat being transferred, and all the excess fluid removed. With regards to injecting under local anesthesia vs general anesthesia it comes down to patient and surgeon preference in terms of comfort and cost as both approaches can be performed with precision, though quite a bit more uncomfortable for the patient when performed awake.

There are many issues regarding different techniques for fat harvest, preparation and transfer. Some of them you have mentioned. There is no good answer which is the best; if it was so we would all be using same technique. You should evaluate results of few surgeons which you consider and make decision based on results not a technique. Hope this helps.

None of those variables are important.
Patient candidacy and provider selection are the two variables that matter most.
Fat transfer to the face is by its very nature unpredictable, imprecise and potentially unforgiving if patients don’t like the outcome. The amount of host tissue available to support the grafted fat varies greatly throughout the face and this leads to different rates of fat survival in different areas.
My best recommendation is to avoid this procedure and stick with fillers.
If someone is going to have facial fat transfer then provider selection is the only variable that is important and that is where patients should focus all their efforts.
Finding the right provide is much more difficult than most people realize. It’s a time consuming process that involves having numerous in person consultations during which patients need to take an active roll in vetting providers.
Best,
Mats Hagström MD