Must Fat Be Overdone for the Body Own Absortion?

Is it true that fat injections have to be exagerated because of the body's absortion and if so how long does it take for it to go back to normal ....and if the "fat transfer is almost permanent"(80 -90%) how does it work? I'm very interested in having this procedure but a bit resistance and won't do it until i have most questions answered

Doctor Answers 11

Fat Survival 80 to 90% Survival In Face

     80 to 90% survival in the face is a general guideline.  Overfilling may be indicated, but it is better to undershoot than overshoot.

Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Fat Grafting - is it necessary to over-fill

Fat Grafting, once a new and novel plastic surgery procedure has gained tremendous popularity in recent years as people realize that loss of volume in the face can be very aging. The result is that more and more doctors have jumped on the fat transfer bandwagon. Many of these doctors do not have the training, experience, expertise or even adequate equipment to perform this procedure in a way that results in a beautiful and natural appearance. Too often today, we see overfilled faces.   My opinion is that the face should not be overfilled with fat. In some cases, this may mean that a patient may elect to come in for a secondary fat grafting procedure in order to achieve the goal they wish.  

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 118 reviews

Fat injections

The amount of fat that is resorbed after reinjection will vary with technique and the location in which it is injected. It does need to be overfilled

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 14 reviews

Overfilling is required to some degree

Yes, you are correct. Not all of the fat that is injected is viable, and some does not survive. The actual percentage of survival is very difficult to ascertain. We have traditionally believe that number to be in the 40-60% range, but some claim even higher numbers now, though again, its quite difficult to actually verify that number scientifically.

In general though, overfilling is required, but it is an art at this point, more than a science. I also agree that it is not prudent to "over do" the overfilling, if that makes sense, as it is always easier to add more fat, than it is to remove fat.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 38 reviews

Fat transfer to the face

Dear Vivian Faith,

  • Fat transfer is done differently with each surgeon
  • Personally, I have certain techniques and amounts I inject to avoid overfilling
  • In fact, since results are permanent, we can be more conservative at first and if you need more volume, a touch up can be performed
  • If you go to an experienced fat transfer surgeon, you will be in good hands

Best regards,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 74 reviews

Fat Transfer Must be Done Methodically

Fat transfer requires knowledge and experience in how much fat will absorbed over time. Different medical studies have showed varying results about how what percentage of the fat goes away. As a result, your surgeon should be careful in the amount that is placed. Overfilling is irreversible and is not easily corrected. The doctor performing the procedure must use proper judgement in the amount that is placed in each area. Fat transfer is an art and should be performed by those with experience with the procedures, so that they know how much will stay for the long term. 

Richard A. Zoumalan, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Overfilling with fat graft

Yes - a little overcorrection is needed, in most cases.  In a recent study, using BRAVA assisted fat grafting, about 65% of the fat was retained at three months after fat transfer.

So, if you want a 100 cc change, for example, about 150cc (100 divided by .65) of graft is needed.  However, this is not always possible in one surgery, and multiple procedures may be required.

Thomas Fiala, MD
Orlando Plastic Surgeon
4.9 out of 5 stars 79 reviews

Overfilling across the board is not a good idea with fat grafting

Yes, fat grafting is truly both an art and a science.  Doing beautiful work requires both a good artistic eye and considerable experience with watching long-term results.  That being said, fat has characteristics that must be understood if the surgeon given that he has experience with this art should abide by.

1.  Overfilling to a significant degree can cause problems because there is a certain degree of variability in fat take and the last thing you want is an overfilled face that can look distorted and abnormal.

2.  That being said, I do overfill the chin and around the mouth slightly because there is a higher resorption rate there. I don't do that in the cheeks or around the eyes where the area is more sensitive and also takes better.  Also, having done this for close to a decade I know how much fat to put in to get what kind of result long term.

3.  Fat also has been used erroneously to fix everything on the face, including lines, lips, wrinkles, and other surface problems.  Fat is a very soft augmentation device that does not fix smile lines and surface problems perfectly.  Fillers do that.  I oftentimes use fillers at a year after fat to touch up my fat results and make them near flawless.  But fillers can be very expensive if used as extensively as fat for the whole face in someone with sufficient aging so I still prefer fat as my main vehicle of delivery in most cases.  Watch the attached video to understand these limitations and benefits more clearly.


Sam Lam, MD, FACS
Dallas Facial Plastic Surgeon
4.6 out of 5 stars 57 reviews

Fat Transfer - Overcorrection?

Most surgeons indicate that at least some of the fat is absorbed by the body over time and, for that reason, you will have less of a result ultimately than you do at the end of the procedure.  One way to address this is to overcorrect with the assumption that it will not all stay as it is immediately post-op.  Another approach is to plan to do additional procedures in the future if the correction is not maintained.  In areas where "you can't have too much" (as is sometime suggested by patients desiring, for example, buttock enhancement) the first approach may be a reasonable option but for many areas of the body, particularly those that are easily visible (such as under the eyes or on the face) I would normally recommend the second approach.  This should, of course, be discussed with you during an in-person consultation with your surgeon.

I hope that this helps and good luck,

Dr. E

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

Fat transfer

Fat transfer is one of my favorite procedures  for rejuvenating the face, either as a stand alone procedure or in combination. 


The procedure adds volume and rejuvenates  overlying skin. The procedure works by transferring fat from a donor site, usually the abdomen, to the face. 

I overfill slightly and that is where the 'art' of this procedure comes in; location of fat placement and the amount of fat used varies between patients. Usually patients are presentable by 7-10 days and the final effects are appreciated by 6 months. 

Good luck !


Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
4.9 out of 5 stars 89 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.