Will Fat Grafting Work After Two Cheek Implant Revisions?

Hi there, I had a porex implant of a certain type, and moved to a bigger size (also porex) as the first implant was subtle to say the least. The current implant however is too big with edges so I want to revert to the initial implant I had and attempt to augment it will a moderate fat transfer. My concern will be that fat will not hold with so much scar tissue because the blood supply might be affected. Is this your experience?

Doctor Answers 6

Facial Fat Transfer or Fat Grafting can improve cheek fullness.

Facial Fat Transfer or Fat Grafting can certainly work to improve the fullness of your cheeks. Newer Fat Harvesting technology such as Adivive can help improve graft survival by placing more viable cells.

You do need vascularity or good blood vessels in the area for the Fat Grafts to survive.

I like Dr. Beraka's suggestion below to remove the implants and wait 6 months for the recipient tissues to re vascularize so the Fat Grafts can be placed into well vascularized tissue.

Having had two implant failures I would go with Facial Fat Grafting or Fat Transfer as the body will tolerate the natural body tissue, fat, much better than an implant.

Will Fat Grafting Work After Two Cheek Implant Revisions?

IMHO, fat transfer is not even in the same league, as cheek implants, for cheek augmentation.  Fat is not reliable or predictable.  I prefer silastic cheek implants or reliable soft tissue fillers like Perlane and Radiesse.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

Yes, the fat will be placed between your skin and the implant capsule


Yes, fat grafting can improve the way an area looks if there is an implant there.  The fat that will be used will and should be placed in the undisturbed tissue above and around the implant not in the scarred tissue immediately surrounding the implant.  If there is a lot of scar in the areas that fat grafting is desired you may need to have two sessions of fat grafting performed.

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 166 reviews

Fat transfer after 2 porex / medpor cheek implants

This can work. I think that with porex / medpor you still have vascularity next to the implant which will support fat parcels and their survival. This is not the case with silicone. I think the scars after the cheek implants could affect the survival of the fat.  With the scars and with the previous revisions you could need more sessions of fat grafting to achieve your desired results.

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.2 out of 5 stars 86 reviews

Fat transfer and fillers have essentially replaced cheek implants.


1)  Unfortunately, your experience with cheek implants is not unusual.  That is why we no longer use them.  I suggest you have the implants removed and do nothing else for six months while the tissues heal and the internal scars soften.

2)  Then fat transfer can give you nice natural fullness in the upper cheeks.  As an alternative, we also think Radiesse injected deep (against the bone) works very well for this purpose, does not involve surgery, and lasts years. 

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Fat transfers in the face work well

Fat transfers work well but require significant expertise.  The nice thing is that it can obviate the need for an implant.  The downside is that the amount of fat that remains after initial healing is inconsistent thereby necessitating repeated procedures.  This is usually a procedure that can be done in an office setting under local anesthesia.  Once you get the final results, it can last for many years.  At some point, permanent implants require revisional surgery--that's just the way it is!  Good luck.

Elan B. Singer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 25 reviews

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