Can fat grafting or Sculptra help my flat mid face, lips, and cheeks? (photos)

Thank you for your question and photos. Sculptra is an ideal solution for stimulating the body’s collagen production, restoring lost volume, and improving skin laxity. This poly-L-lactic acid formula can effectively thicken the skin on the cheeks and gradually increase facial volume over the course of a few months. Results from Sculptra injections can last for up to two years or more. I recommend scheduling an in-person consultation with an experienced, board-certified injector. They will be able to assess your concerns and determine the best treatment option for you.

At age 26 you should not need volume replacement in your face. Your soft tissue coverage is actually quite ideal. Based on your pictures the soft tissue coverage of your facial skeleton bone is smooth continuous and very nice. it’s the underlying bone structure that’s giving you cause for concern.
Plumping up the soft tissues in certain areas is not the same as having been born with a different facial skeleton structure.
Grafting fat is emphasized unpredictable and unforgiving in relationship to what can be done with fillers.
Were you happy with the outcome of the filler treatment?
Before considering something permanent volume augmentation should be worked out where you are very happy with the outcome on a consistent basis using fillers and then have the same provider convert to longer lasting fillers or potentially grafting fat.
Grafted fat will survive based on where you have more abundant thickness of soft tissue covering. The thickness of soft tissue coverage of the face varies substantially from area to area and this has a drastic impact on where and how much of the grafted fat survives. Fillers on the other hand are not dependent on host tissue and are therefore more predictable and certainly more forgiving.
If you end up doing fat transfer and don’t like the results then what happens next?
Facial fat transfer is not straightforward and if you opt to go that route I suggest spending a fairly substantial amount of time with the provider first working with fillers to get accustomed to wear volume looks good and finally doing facial fat grafting gradually in stages.
To get an accurate assessment in regards to what the underlying actual issue is I suggest consulting with oral surgeons or plastic surgeons who then craniofacial fellowship training.
Your individual facial appearance which is true for everyone especially young people is purely based on bone structure.
It is primarily the relationship between the forehead (Frontalis)the mid face (maxilla) and the lower third of the face or the (mandible).
Best,
Mats Hagstrom MD