Fat Injections - Can It Be Permanent?

Hi! I`ve heard alot about fat injections, but im still very confused! If you get fat injections under your eyes or in labia majora, is that permanent? Or will it be absorbed by the body? Thank you!

Doctor Answers 11

Fat injections are long lasting if done correctly

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If you frequent various plastic surgery blogs, there is a wide variation in the types of techniques that surgeons are using. Thus, there is a wide variation in their results and their opinions about whether fat injections are permanent.

When fat transfers are done correctly, a large percentage of the injected fat cells do indeed survive and are permanent. When done incorrectly, they don't last very long.

The American Society of plastic surgeons just published a position paper on this. Basically the experience of the surgeon and the technique matters a lot. Do not use fat extracted by UAL. Blasting the cells with heat (Laser or ultrasound) is not a good idea.

I discuss why fat grafting is long lasting when done correctly inside the video, but you can also take a look at my blog post web reference for more information.

Baltimore Plastic Surgeon
4.5 out of 5 stars 98 reviews

Long-term results with facial #fat injections to improve under #eye area

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Hi 474867anon in Norway,

Fat injection is a good option for non-surgical facial rejuvenation, including lip augmentation or cheek enhancement. Fat may provide natural, soft enhancement of the cheeks, lips, and under eye areas. Fat is typically harvested from the abdomen, purified, and injected into the desired areas.

However, there is a certain level of unpredictability with fat injections as always less than 100% of the fat survives long-term. In addition, the face continues to age naturally, so touch-ups may be required for some patients. Speak with a plastic surgeon who can provide a comprehensive evaluation and help determine appropriate options for you. Best of luck.

Dr. C

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

Fat Grafting Can be Permanent - Things to Discuss with your Plastic Surgeon

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There is  a wide range of techniques, instrumentation and experience among the surgeons that perform this surgical procedure.  Because of the tremendous variability in all of these factors, there is tremendous variability in fat grafting results.  To perform fat grafting successfully and reproducibly a surgeon must employ careful preoperative planning, appropriate instrumentation and meticulous surgical technique.  It is not something you can 'rush through' or spend just a few minutes on during a larger surgical procedure.  The unfortunate reality is that not everyone who performs fat grafting is willing to put in the level of education, training, investment in instrumentation and operative effort required to produce aesthetically ideal results.
One must also have an aesthetic vision for ideal and youthful-appearing facial fullness.   Just like traditional facelift surgery can be overdone or performed incorrectly to produce an unnaturally tight, pulled, 'windswept' look, fat grafting can be overdone to produce an excessively full and even bizarre postoperative appearance.  Too much fat grafted into any area (or any fat placed where it doesn't belong) looks unnatural.  It's analogous to breast augmentation results: if the surgeons selects an appropriate implant volume and positions the implants correctly, the patient gets a beautiful, natural-appearing breast enhancement.  If the surgeons stuffs a pair of 500cc implants behind the breasts of an average-sized patient, then that patient ends up with a cartoonish 'boob job'.  I think many of the unfavorable results in fat grafting are from the overzealous placement of excessive amounts of fat, which may have been the inevitable response to the recent paradigm shift in aesthetic facial surgery: away from the 'wind tunnel look', and towards the restoration of soft tissue volume.

For transferred fat to truly qualify as a 'graft' the following must happen: living tissue must be transferred to a new location, and that tissue must gain a blood supply at the new location which provides oxygen and nutrients which allow it to persist indefinitely as living tissue.  We know that with appropriate instrumentation and technique this is achievable, so one of the opinions expressed in this thread that "most of the cells from fat injection are dead " is simply untrue (and structural fat grafting, to be clear, does not involve 'injection' of fat).  MRI studies have shown that with appropriate technique grafted fat persists long-term as living, vascularized tissue in the recipient site.
It is also well-established that adult human fatty tissue contains stem cells that have the capacity to repair damaged or injured tissues, and stem cells can be concentrated during the fat harvesting process.  This effect has applications in both cosmetic and reconstructive surgery.  Fat grafting is now being used, for example, as a means to stimulate the repair of chronic, non-healing wounds.  Several centers have reported on fat grafting immediately below non-healing chronic wounds resulting from radiation therapy for cancer, with rapid improvement and eventual healing of wounds for which no other wound treatment was successful.  The development of stem cell therapies involving the harvesting and processing of viable human fatty tissue is one of the hottest topics in both clinical and experimental medicine today.
When performed correctly fat grafting actually has the capacity to heal, revitalize and rejuvenate the local tissues at the recipient site.  I have treated a number of patients with facial fat atrophy following overly aggressive 'non-invasive' rejuvenation treatments including Thermage, Fraxel and IPL.  Most of these patients report not only an aesthetically  pleasing and permanent improvement in facial soft tissue volume, but also an improvement in the quality and vitality of their facial skin.
I perform extensive facial fat grafting during most of my facial rejuvenation procedures, and it is the very first thing I do - before making any incisions to lift the brows, eyelids, face or neck.  Fat grafting allows me to obtain results that are simply not possible with conventional, subtractive surgical techniques alone.  Patients frequently return for grafting of additional areas after their initial experience with strucutral fat grafting.  To characterize it as the pointless and potentially harmful placement of non-viable tissue is an opinion only, and it is an opinion with which quite a number of plastic surgeons who successfully rejuvenate faces (and breasts and bodies) with fat grafting would vehemently disagree, myself included.
Solid fat/fascia and fat dermis grafts are another means by which facial soft tissue volume may be significantly and permanently enhanced.  As with fat grafting, survival of the grafted tissue is variable and some of the graft material is reabsorbed.  As with fat grafting, potential complications such as infection and cyst formation are possible.  And as with fat grafting, appropriate preoperative planning and surgical technique are required in order to obtain ideal and lasting results.  In my opinion structural fat grafting is more versatile, as fat can be easily and rapidly added to any tissue plane (level); and it has the added benefit of the ‘stem cell effect’ which is difficult to quantify but unquestionably present in many cases.
Both structural fat grafting and fascia-fat (or dermis-fat) grafting can be competently performed (or not) by Board-certified plastic surgeons.  Neither should be trademarked or considered proprietary.
As with any surgical procedure take time researching your plastic surgeon. Schedule several consultation, view many photos from many patients, each from multiple perspectives (start by looking at photos on this website) and speak to former patients of any plastic surgeon you are considering.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Fat graft

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Fat grafting is technique dependant. Some of the fat is absorbed, but these days should be minimal. There is also stem cells in the fat injected and that stem cells eventually differentiate to fat.

For the face expect to redo the fat transfer a second time,

For the labia majora, 90% of th fat stays. But expect swelling and bruising

Samir Shureih, MD
Baltimore Plastic Surgeon

Fat injection balancing act

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The truth is somewhere in between. Fat injections can be permanent but a significant  amount of the injected fat will resorb. Predicting the final result requires an estimate of the final outcome of thes two opposing actions.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Fat Injections Designed To Be PERMANENT

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The goal with any fat injection is for it to be permanent.  The problem, though, is that you just do not know how much of the fat your body is going to resolve on its own.  In some people, 50% of the fat will be resorbed over the first year, which is why it is not unusual to need multiple fat injection treatments to finally get to your desired goal.  Once there, though, it should be very long lasting.  I hope this helps.

Fat Transfer IS as PERMANENT as any filler can hope to be

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Regarding: "Fat Injections - Can It Be Permanent?
Hi! I`ve heard alot about fat injections, but im still very confused! If you get fat injections under your eyes or in labia majora, is that permanent? Or will it be absorbed by the body? Thank you

Fat, like ALL living tissues, require an efficient blood supply for oxygen delivery and removal of metabolic byproducts. In the process of fat grafting, fat cells may be destroyed during harvest (trauma of suctioning), preparation (washing away blood and dead cells), waiting to be grafted / injected into their new location and after grafting by not getting a blood supply fast enough. As a result, not all the fat grafted makes it (or "takes").

The fat which survives will then be subject to the same hormonal influences that the fat in that location would otherwise be subject to. Put another way, grafting a deflated, aging face of a woman in her 60's would make her appear younger BUT facial aging would continue at a slower rate than before and the clock cannot be reversed from their 60's to 20's.

Successful fat grafting is as "permanent" and ideal as any fillers can hope to be.

Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

Fat Grafting and How Long Does It Last

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Fat grafting can be permanent but what I tell my patients is that not all of it is permanent.  Some of the fat that is injected does stay but some die off.  So I say that to make the result permanent usually several sessions need to be performed to reach the ultimate result.

In general I say that about 40-50% of what is injected remains, but again this is just an approximation.

Hope that helps.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

Fat injections may be long term

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Permanent, maybe, but that is hard to guarantee and prove. There are many people who have long term (years) augmentation from one or more fat injections.  Fat injections are fat grafts. Some of the cells may live in the new environment, but not all. Several sessions can be done to get long term improvement. Some patients don't retain the fat grafts even after multiple attempts.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Fat Grafting - Permanent

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Fat grafting when performed properly, is a permanent procedure. The fat has to be gently harvested, purified, and injected in order to achieve these results.  When choosing a fat grafting surgeon, be sure to see before and after photos of their patients that are over a year after the procedure to determine how their results are.  Click on the link below to see more information about fat grafting and the results. The first patient is 1 year and 3 months after only one round of fat grafting. 

Jacob D. Steiger, MD
Boca Raton Facial Plastic Surgeon
4.9 out of 5 stars 71 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.