Fat Transfer to Face While Fillers Are Still Present?

I routinely perform microfat injections on my patients when facial fillers are already present without issue.   The filler will gradually dissipate over time and the transplanted fat which is essentially permanent takes its place in terms of providing the volume correction.  Fillers may still be required to adequately correct marionette lines as these are more of a skin (dermal) volume or collagen loss issue and fillers are a better intradermal corrector than fat. 

Yes,  the short answer is that it is okay to inject fat into face which already has previous fillers in it.  They are not mutually exclusive treatments.

Dr Taban

If it is advisable to have facial fat grafting performed while injectable fillers are present in the face depends on which fillers were injected and where they were injected. When dealing with plastic surgery of the face you do not want to do anything that will make a procedure more risky, difficult or unpredictable. In every facial procedure I perform, I try to “set the stage” for success and I always strive for precision and accuracy. I recommend that my patients steer away from facial fillers prior to facial fat grafting because it can obscure the true shape and form of the underlying face. Some injectable fillers last longer than others so you would want to make sure that the majority of whichever filler was injected had resolved prior to your facial fat grafting procedure. It will certainly not hurt you to do facial fat grafting while fillers are present but it can certainly diminish your overall chances of having the best possible result from your surgery. If the fillers were injected someplace other than the area you intend to address with the facial fat grafting, there is no longer any real issue with having the surgery and your only decision left is to choose a surgeon with a vast experience in facial fat grafting and facial reshaping.. 

Fat transfer to the face is possible when you have had fillers.  In general, there is a variable with fat transfer, and if there is Radiesse injected in your face, it may be even more variable.  For example, one area may take better than the area that has the Radiesse because the vascular supply may not be as good.  Often in patients who have had injectable fillers, I prefer to use injectable fillers.  They are much more predictable in terms of results, and they can be modified.  Fat transfer is very difficult to reverse. 

I think that injecting both will not cause problems but may create issues when the fillers begin to fade. This means that whatever filler was placed will gradually absorb. If the fat was placed while it was still full, once the filler has absorbed , the contour attained will change. This means that more fat (or filler) may be required to maintain the correction but I dont think this is a big deal since repeat treatments are required with both fat and fillers.

I find injecting fat in areas treated with filler works fine depending on what filler was there. This doesn't mean much, but injection of any material post filler means the area is not virgin territory. Radiesse is especially cumbersome, given that it is a thicker substance and injecting the fat will take a bit of effort, in addition the material should be injected so that it evens out well with old filler there. Other than that, it should not be a problem.

The fillers should not interfere with the fat transfer however, you might want to do some research into the long term viability of fat transfer, say to the cheeks, versus Cheek Implants.  The former still has issues with absorption which are not an issues with silastic implants.  For facial shaping, IMHo two things are the most important


Great aesthetic judgement

Reliability to create the proper shape

Shaping ability (implants come with the proper aesthetic shape) which must be created with fillers and fat


 

Having fat injections placed at 5 to 6 months after fillers were placed is not an issue. The only problem might be that if the fillers are still present they may give a false sense of volume to the cheeks. As time goes on and the fillers disappear the cheeks will look smaller. It may be difficult for your surgeon to determine the amount of fat needed to account for the eventual loss of the current fillers.