Should I start by Juvederm Voluma and Radiesse before considering full face fat transfer?

Hi doctors! I am 30 years old, i lost a lot of volume in my face specially cheeks. My face becomes thinner and longer. I saw a qualified surgeon asking him fat transfer because all good things i read about it, more natural look, alive component and also i feel i would be so Happy if i have my 25 years old full face back. But my doctor just tried to convince me that i will have a good look with juvederm voluma. May then consider fat transfer 9 months after fillers without problems? Thanks

Doctor Answers 8

Should I start with injectable products before fat transfer?

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This is a great question. The advantage of "permanent" fillers is that they are permanent! The main disadvantage of permanent fillers, however, is that they are permanent! Just as you are less likely to jump into a pool before checking water temperature and depth, I advise many of my patients to see if they like the results of fillers first with an off the shelf, temporary product before moving to something permanent. When I use fat in the face, I prefer to employ harvest techniques that generate a more stem cell rich fat and, in man cases, I will mix in either platelet rich plasma or Stromal Vascular Fraction (stem cell rich solution extracted from fat) in order to enrich the grafts and enhance outcomes. I hope that my answer is helpful. 

Fat will behave differently than Voluma

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Voluma and fat grafts share some similarities but are also different in many ways.

For one, Voluma can last for up to two years and fat can last forever.  Fat has the potential to die and totally reabsorb within weeks to months; Voluma will not go away that fast.

Next Voluma has the ability to actually tack the soft tissues down to the bone, providing more elevation in the soft tissues.  Fat is essentially just a volume enhancer.

Lastly, if you need more Voluma, you just pull it off the shelf; fat grafts have to be harvested surgically.

To specifically answer your question, your surgeon is the best resource for you, but you certainly could use fat later if you're not happy with the Voluma.  I'd prefer you to just use more Voluma, but you will have options.

Voluma before Fat Transfer

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At your young age I have found that Voluma and Sculptra provide wonderful results in filling facial hollows.  Fat transfer is quite invasive and not permanent either.  Please consult a board certified dermatologist with expertise with these fillers.  Best, Dr. Green

Voluma vs Fat Transfer

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In my experience, fillers such as Voluma, Restylane Lyft, and Radiesse provide an excellent, off the shelf treatment option for cheek augmentation.  Fat transfer can be appealing for some patients because it represents your own tissue but the truth is that fat transfer is often not permanent and is much more invasive.  It requires a fat harvesting procedure from elsewhere in your body and it requires a larger needle or cannula to inject into the face compared to regular fillers. In my practice, I stopped doing fat transfer about ten years ago and I have no plans to go back.

Richard Ort, MD
Lone Tree Dermatologic Surgeon
5.0 out of 5 stars 28 reviews

Benefits of Voluma

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Voluma is a fantastic product for restoring volume loss in the midface. Due to your age, you may consider trying an injectable option like Voluma before proceeding with fat transfer. Voluma injections will have no effect on future treatments, so it will not be a problem if you decide to proceed with fat transfer in the future. One of the benefits of Voluma is that it’s a hyaluronic acid, meaning that it can be dissolved at any time. Many patients find comfort in the fact that it’s a safe product along with being very effective for treating volume loss. I recommend scheduling a follow up appointment with your doctor to discuss both options in more detail. It will give you a chance to ask questions that you might have about Voluma and review the doctor’s recommendations for you.

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.1 out of 5 stars 9 reviews

Fillers or fat transfer

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Fillers are a great way to add volume without the permanency of fat transfer.  They will gradually fade over time and it gives you a chance to play with just how much volume you would like.  
Once you and your surgeon are confident in where and how much volume you would like, then a fat transfer can be done.

Camille Cash, MD
Houston Plastic Surgeon
4.9 out of 5 stars 36 reviews

Voluma for plumping cheeks

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I think is a reasonable plan to try Voluma prior to fat transfer.  It is an easier procedure, and you can see how the results will look prior to having fat transfer.  

Fat Transfer

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Hi, You can go either way and you will be happy with the results.

Importantly you have decided that you want to restore volume and there are two ways to do it.

If you understand and are willing to have a fat transfer then I don't see the need to try a HA  filler first.

Generally however I believe your surgeon's advice is sound and applies to people who have not had fillers before and are not clear on their treatment goals.

Problems that can occur with both  filler or fat are asymmetry, lumpiness, bruising, swelling and numbness.
Thankfully these are uncommon.

Having a filler first does not prepare you to have fat later especially since you already  have decided what you want to achieve.

The major advantage of  a HA filler is that it is reversible and wears off over time so if you end up not liking  'the look' (rare in my experience, most patients cannot get enough!) you will will end up just like your pre treatment self in a few months.

I hope that helps.

Best Wishes

Peter Laniewski, MBBS, FRACS
Sydney Plastic Surgeon

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.