Do Fat Injections Work As a Facelift?

Question

I am a 48 year old woman and I am starting to get the droop on my cheeks. I do not wish to have surgery. I have had Scuptra, Juverderm and Radiesse injections and all have helped, none are permanent. I have been hearing that fat can be injected to lift the cheeks and that this is permanent. Of course, I understand that this would have to be performed by a board certified plastic surgeon. If this true, can you recommend the best plastic surgeon to do this Los Angeles?

Brent Moelleken, MD · Answer

It sounds as if you have had many temporary fillers and some semipermanent fillers.

	Our philosophy about fat injections is that fat that is used for fat injection is first obtained by a suction process.  This damages the cell walls of many of the fat cells.  The fat is usually centrifiged at high speed and then injected through a needle.  It is no wonder that most of the cells that are injected are already dead when they are injected. The viability of fat injection specimens varies from 5% to 25% in carefully done studies.  Our studies were done with dye exclusion methods and showed viability around 20-25% in very carefully harvested specimens.  Other studies done with metabolic uptake methods showed viability much lower.  Some studies that just use microscopes to tell how viable cells are are not, in my opinion, valid because they are not exact enough.

	For this reason, we use primarily nontraumatized fat fascial grafts for facial volume augmentation.  These consist of strips of tissue that are untraumatized when they are harvested.  They are then placed in pockets within the face.  each area is treated slightly differently and has certain requirements and limitations.  We have termed this process LiveFill(TM). 

	In patients your age who are noticing the changes you describe, a facelift is usually necessary to achieve the best result, along with the grafting technique above.  However you have decided not to have "surgery", so fillers alone will still give you a good result, just not the best result.

	There are many fine surgeons in the Los Angeles area, and it is wise to consult with several you feel to be the best before making your final decision.

Ronald J. Edelson, MD · Answer

please do not get fat injections on the face.  They are a total waste.  I can understand that at 48 you are not ready for a facelift even though that may well be the best option.

Ivan Wayne, MD · Answer

I have been doing fat transfers to the face for over 7 years. Patients who have a lot of thinning but good skin tone may get by with fat grafting alone to rejuvenate them. Patients who have thinning and a lot of skin aging as well as laxity of the tissues will typically not get as much improvement with the fat. The simple way to view this is: fat is great at treating the thinning problem, not great at treating sagging due to skin and facial laxity.

Ron Shelton, MD · Answer

Fat injections have been used for many years, with improvements in techniques allowing the fat to be injected as smaller doses per area, leaving a smoother result and a better chance for survival. Although it is not guaranteed to survive, fat injections do have a chance to provide long term survival as it is a graft and the cells can live in their new area. Both dermatologic and plastic surgeons are known nationally to provide excellent pan facial augmentation with fat injections. Fat injections may require several treatments as all the cells won't necessarily live after the first treatment.

Robert W. Kessler, MD, FACS · Answer

There are three issues which must be addressed in the aging face. Facial structure, volume and skin quality. Surgical facelifts can restore tissue to there appropriate positions and remove lax inelastic skin. Volume can be replaced with fillers or your own fat and the skin can be addressed by skin care, peels  or laser.

	You may not need to have all three to rejuvenate your face but your surgeon wil be able to advise you at your consultation.

	Good luck.

Do Fat Injections Work As a Facelift?

Answers (9)