Fat transfer vs other options for brow bone augmentation —what is your opinion? (Photos)

Question

I'm a young Asian male seeking to get deeper set eyes. Can fat transfer to the brows create a moderate difference (I had fat transferred to my infraorbital and midface area already). I'd consider other options to like HA paste, PMMA, or even a custom implant if fat grafting can make a difference but I prefer to work with natural grafts. I also want to fill the forehead a bit so my suprabrow break does not become more prominent. Can a doctor please let me know about their thoughts on this?

Jason Emer, MD · Answer

you will need an implant, or bone break-type surgery for the best long term outcome. fillers can be used but will be less defined and/or predictable.  Best, Dr. Emer.

Andrew Kornstein, MD, FACS · Answer

I would strongly recommend fat grafting for many reasons:(Fat graftingfat cells for volume and stem cells for anti-aging all in one grafting procedure)1. More than twenty years personal experience, including a publication specifically on forehead and brow fat grafting that documents aesthetics and retention over many years.2. It is the only grafting material that can be easily contoured for inherent facial asymmetries, and therefore can be used to optimize aesthetic contour as well as facial asymmetry3. Implants can move and shift and often create pressure erosions in the bone.4. Adipose derived fat grafts are the body's most potent stem cells; their growth factors including vascular growth factors slow or stop facial aging by maintaining/restoring blood supply to the facial skeleton5. After more than twenty years of fat grafting I can personally validate these claims and advantages.In sum, fat grafting allows for aesthetic contouring including enhancing symmetry. It replaces "like with like" as skeletal support for the facial soft tissues is both bone and fat pad. There are no issues with palpability, asymmetry, movement or erosion as with implants.Hope this helps

Barry L. Eppley, MD, DMD · Answer

While fat injections can be done for brow bone and forehead augmentation, beyond how well they may survive, is that they are not going to give a defined shape. They are best for more amorphous or less defined facial areas or features such as the midface where generalized fullness/projection is needed. But getting the needed push for brow bone augmentation and keeping a distinct feature like a brow bone break with forehead augmentation requires the defined shape of an implant for which a custom forehead-brow bone implant works best.

Fat transfer vs other options for brow bone augmentation —what is your opinion? (Photos)

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