Facial Fat Transfer Questions?

I am 51 and would like fat placed in my marionette lines. A few questions... 1) What is the most results-oriented, easiest and safest place to harvest the fat? 2) Can both harvesting and placing the fat be done safely without any sedation...only local numbing of the area? 3) Do you advise first having fillers put in the marionette lines so I can be sure I like the look? 4) About how does fat last compared to fillers? Thank you!

Doctor Answers 7


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 1) What is the most results-oriented, easiest and safest place to harvest the fat?
love handles.

2) Can both harvesting and placing the fat be done safely without any sedation...only local numbing of the area?

3) Do you advise first having fillers put in the marionette lines so I can be sure I like the look?
yes.  plus, fat doesn't incorporate that well in this region.

4) About how does fat last compared to fillers?
Depends on area.  fat survives best where there is fat (cheeks).  Less so in lips and lines.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 53 reviews

Facial Fat transfer...

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Fat transfer is a natural approach to restoring a youthful look to the face.  I like to harvest fat from the outer hip and thigh.  The fat tends to be less bloody and lasts a long time.  The procedure can certainly be done under local anesthesia without a problem. You don't really have to have the fillers done beforehand because the fat will fill the areas nicely.  As the fat is reinjected over the course of a year, a long term result of 2-3 years can be acquired.  Unfortunately we all continue to age over time so additional treatment will be needed in the future, but fat injection is ultimately very cost effective.  Be sure to speak with a board certified facial plastic or plastic surgeon about any of the questions before making any decisions.


Facial Fat Transfer vs. Fillers

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To answer your questions accordingly:

1. Fat can be harvested from any part of your body. You and your plastic surgeon can decide which areas would be of most benefit to you.

2. Harvesting and Transfer of fat can both be performed under a local anesthetic.

3. Having a temporary filler is a great way to decide if the results of fat transfer is something you may like.

4. Fat lasts forever, but the the survival after transfer can be variable. Fillers are temporary and require reinjection every 9-12 months or so.

Thanks for your question!


Gregory C. Park, M.D.

Gregory Park, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 176 reviews

Rejuvenating the Face With Fat

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At age 51 it is rare that fillers (fat being the perfect filler) will provide much improvement if cheek tightening and/or elevation is necessary. Even if midface surgery is indicated both fat transfer and midface surgery can be effectively done with local anesthesia- sedation is not necessary but recommended. The fat is usually taken from the abdomen or the flanks using a tumescent technique. When the fat is processed carefully and injected with thoughtful technique, the fat graft "take" should be close to 100% when injected in the less mobile parts of the face and at least 80% when injected in the marionnette lines and around the mouth and lips. I do not recommend a trial run with temporary fillers as the result will frequently be inadequate and costly.

Paul S. Howard, MD, FACS
Hoover Plastic Surgeon

Fat transfer questions...

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Hi. I only perform fat transfer under local anesthesia and 90% of the time obtain it from the abdomen. The marionette area is great for fat transfer, however, at 51 years old, you should consider other areas as well to maximally benefit from the procedure- other areas include, cheeks, under the eyes, temples, nasolabial folds, lips, brow etc (If you are going to go through the costs and process, you may as well make the most of it). As for the actual procedure, once the local anesthesia is in, the procedure is painless, I regularly have patients come in for the procedure, which lasts just over an hour, and go home themselves right after the procedure. As for what to  expect for the results, your surgeon should be able to show you before and after pictures, and you can always try temporary fillers, however, I find the results from fat are much 'softer' and more refined than temporary fillers and after about 3-6 months, you should also notice an improvement in your skin tone, which is not achieved with fat. Hope this is a good start for you.

Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 104 reviews

Great fat grafting questions

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Sounds like you are putting some good thought into your procedure.  Here are my answers to your questions:

1. I prefer to harvest fat from the abdomen, hips, or thighs.  Wherever you have a little extra will do as a good harvesting location.

2. It's definitely possible to harvest and inject fat under solely local anesthesia.  This becomes more difficult as you add more areas to graft.  I prefer to do most of my fat grafting under general anesthesia since it allows me less scars and less distortion of the area I'm grafting.

3. I always recommend fillers for the marionette lines first.  Fat is a thicker, more globular substance that can be difficult to use for finer wrinkles like marionette lines.  I prefer fillers for actual wrinkles, fat to fill in hollow or depressed areas (like the cheeks or undereye areas).

4. Fillers last up to a year, fat can last several years.  The difficulty with fat is its unpredictability in how much takes.

Anthony Youn, MD, FACS
Detroit Plastic Surgeon

Fat Harvest and Transfer/Transplant Questions

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Hello, happy to answer your questions.  I do a fair bit of fat transferring in my practice and your questions are great ones!


1.  I would Harvest from the inner thighs or from the abdomen.  Each has its own inherent risks and benefits but both can be done quite safely.

2.  With a good local block and injection of saline, epinepherine and lidocaine the area can be quite numb.  Being awake may not be problem if you dont mind knowing what is going on.  Usually a light touch of sedation is quite safe.

3.  FIllers are great way to "test drive" how things will look

4.  Fillers ususally last 6-9 mos, fat is supposed to last for decades

Michael A. Carron, MD
Detroit Facial Plastic Surgeon
4.9 out of 5 stars 42 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.