Fat Transfer, Fat Grafting, Fat Repositioning, Fat Injections? What is the Difference?

Hi, I read about fat transfer, fat grafting, fat repositioning and fat injections (for under-eyes problems) and I want to ask what is the difference between them? Or is it the same thing? And it is safe to do any of these procedures done for under-eye correction? I sent a photo of mine to a plastic surgeon and he suggested fat injections. But I heard that you can get blind from this procedure. Thank you for answering my question. Jerry

Doctor Answers 7

Difference Between Fat Grafting, Injection, Transfer and Repositioning-Important

Thank you for your great question.

There is an important distinction-injected fat does not survive as well as fat that is a composite (whole piece of fat) fat graft.

These terms not only confuse patients but many surgeons use them improperly. A graft refers to a surgical procedure to move tissue from one area to different area on the body. Technically harvesting fat from one area of the body and injected it into another area is a graft but more properly should be called Fat Injection or Fat Transfer. I use Fat Grafting to describe the transfer of a whole piece of Fat into another body area. Technically this s more accurately described as Composite Fat Grafting. I use the following distinctions:

  1. Fat Injection or Fat Transfer-harvesting particulate fat or fat cells and injecting the cells into a different area-usually the face and eyelid area. Can also be done on the breast and other body areas that need volume.
  2. Fat Repositioning- Leaving fat attached to its blood vessels and pulling or moving it into a nearby area-most commonly in the eyelid area
  3. Fat Grafting-I use the term Fat Grafting to refer to Composite Fat Grafting in which a whole piece of Fat is removed from one area and transplanted to a new area-usually the eyelid

I hope this helps.

Fat Grafting Facts

Fat transfer, fat grafting, fat injections, and structural fat grafting are basically the same.  This involves taking live fat cells, protecting and processing them, and re-injecting or placing them in an area where more fat or bulk is needed.  Some special terms are used for marketing purposes, but it is all fat grating.  In regards to safety for under eye correction, there is a greater possibility of irregularity of result with fat than with fillers.  That is because it is difficult to place very tiny strands of fat under the very thin skin in the tear trough area, and therefore slight lumpiness is sometimes seen and is not desirable.  However, there is a way to combine fat grafting with blepharoplasty where the fat in injected underneath the skin into the bulk of the orbicularis muscle of the lower lid.  Regarding blindness, the number of cases of blindness is infinitesimally small and while it is a risk, it is a miniscule risk.

James Carraway, MD
Virginia Beach Plastic Surgeon
4.3 out of 5 stars 9 reviews


You are absolutely right. This can be confusing terminology. In general fat grafting and fat transfer are different terms for the same thing:  fat is removed from one area of the body [hips, thighs, abdomen, etc] via liposuction, and then injected into other areas of the body [face, hands, breasts, etc].

Fat repositioning is usually done with lower blepharoplasty, where lower eyelid fat is repositioned into the hollow beneath the eyelids, instead of simply excising this. I generally do this procedure for milder cases of prolapsed eyelid fat in younger patients who do not need fat grafting to the other parts of the their face.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 41 reviews

Difference between Fat Grafting and Fat Repositioning in Lower Eyelids

Regarding your question about filling in depressed lower lid areas where it joins the cheek: You have a few options. Fat can be re-positioned from the lower lids to fill this depression ("tear trough"). This means that the blood supply to the fat is still present and it is just released from the fine membrane (called arcus marginalis)  that holds it back and directly positioned in that area. Other choices include injection fat as a fat graft -this procedure has many names all meaning the same thing such as: lipoinjection, fat injections, fat grafting, fat transfer, etc.

Blindness though a possible tragic complication is fortunately very rare.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

Fat transfer for under eye problem

The bulge tnder the eye that makes one appear tired is typically due to a protrusion of a fat pad. This can be repostioned as part of an eyelid surgery, in which it is rotated so that it smooths out the contour. Fat injection, fat grafting, and fat transfer are all terms for the same thing. In this case, the groove along the bottom of the bulge is filled in. The decision between these two depends on a lot of factors that can only be determined at the time of consultation. Blindness is an extremely complication rare but can occur with either type of procedure.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 54 reviews


Fat grafting, Fat transfer and fat injection are all the same procedure, different termenology.

Fat repositioning, means that the fat pockets in the lower lid are not taken out but positioned or moved to hollow areas to fill it.

Blindness has been reported when injecting fillers especially near the eye and nose.

That is why all fillers and fat should be injected with a blunt cannula that does not piece the vessels and the filler does not block the blood vessels.

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

Fat Injections : what it all means

Hi Jerry,

Let's start by going over some definitions:

1. Fat Transfer - this is where fat is removed (harvested) from one area of the body (belly, thigh, buttocks) and transfered (injected, grafted) to another (cheeks, under eyes, breasts).


2. Fat Grafting - this is another term for the process of injecting harvested and processed fat into another area of the body. In essence it is a tissue transplant much like when a skin graft is done and therefore the word "grafting" is used.


3. Fat Repositiong - this is a surgical technique used in the lower eye to move fat from one area to another (repositioning of nearby fat to another area). It is most commonly used to address under eye hollows and is not the same thing as fat injections.


4. Fat Injections - this is a generalized term for the procedures #1 and #2 described above.


Fat injections to the lower eye area are complicated and need to be done in the right way for the right anatomy. Anytime work is being done around the eye there is a risk of vision loss or vision defect. However the eye is a complex area and certainly some procedures have a far higher incidence of risks than others - best to discuss with your doctor during the consultation to evaluate what the good things and what the bad things are that could possible happen.

Good luck to you,

Dr. Kamran Jafri

Kamran Jafri, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 11 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.