Fat VS Filler. I have almost absolutely no fat on my face?

Can filler completely replace all the lost fat? Does it look the same as results from fat transfer? Can anything really look like natural plump fat in the face?

Doctor Answers 1

Fat loss on face fat grafting vs. filler

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Fat grafting provides results that are far superior to results of injectable fillers. One guiding principle of reconstructive plastic surgery is short and simple: "Replace like with like." Specifically, where tissue is missing, restore the defect with the same tissue whenever possible. If bone is missing, use a bone graft. If muscle is missing, use a muscle flap. So if fat is missing, the ideal solution is obvious.

I would recommend that you absolutely avoid the superficial injection of fillers designed to be long-lasting, as granuloma formation (chronic inflammatory nodules due to the body’s immune response to foreign objects) will be a frustrating, visible, difficult to correct problem if it occurs where these materials are placed close to the skin. I would absolutely stay away from Artefill (both superficial and deep placement) as it contains a form of polymethylmethacrylate, which is used as a cement for joint replacements in orthopedic surgery.

Another product is Radiesse which contains calcium hydroxyapatite, the mineral component of bone, which also can induce chronic granuloma formation. I have seen patients who said they were pleased with their Radiesse treatments on a boney area, but others who regretted having that material injected. So results are widely variable depending on who is injecting it and into what anatomic location. It’s too dicey for our practice.

Take a look at the fat grafting before and after images on my website. You can see for yourself the long-term improvement some of my patients have experienced following a fat grafting procedure

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