Could lingering Juvederm affect fat graft getting blood supply to nasolabial folds?

Question

I want to get fat transferred to nasolabial folds. 8 years ago , I had juvederm 1 ml total injected to my nasolabial folds .looks visibly gone now , but I was curious if any remains of it lingering would affect fat getting a blood supply to that area . I’ve seen a doctor in Australia say remains of filler years later still show on an mri as white spots . Would I have to use hyluronidase to get rid of the remains if any despite filler only supposed to last just a year? Can fat still take even when filler was there before ?

Mats Hagstrom, MD (license on probation) · Answer

Having had HA fillers in the past should not have any affect on facial fat transfer.
I would however like to point out that grafting fed in nasal labial folds tends to give a very different results than using fillers. fillers can quite easily be placed aggressively in small areas including right up under the dermis. fat on the other hand tends to be much better forgiving diffuse overall volume. To fill the nasal labial fold requires very precise filling in a small area. drafting fat in the area can make it look bulky and clumsy and is not ideal.
Fat grafting compared to fillers is imprecise, unpredictable and unforgiving.
If you want longer lasting results and then start using long lasting fillers like radiesse.
Fat just doesn’t do well in the nasolabial fold in my opinion.
That said the one single most important variable when it comes to a facial fat transfer is choosing the most talented and experienced provider. The learning curve to getting consistent quality results for these procedures is quite steep and long.
Before committing to permanently changing your face in an irreversible way I would for sure confirm the provider can deliver consistent quality results by asking for seeing numerous before and after pictures confirming that after pictures were taken at least three months from the date of the procedure.
Simply seeing a handful of pre-selected before and after pictures is insufficient to get a clear understanding of what average results look like for each individual provider.
Patients should properly vet plastic surgeons by asking them to show their entire collection of before and after pictures including showing various outcomes including excellent outcomes, average outcomes and less than outcomes. experienced honest confident providers should have no difficulty complying with these requests.
For facial work I recommend patients stay with fillers rather than fat transfer unless they are very certain of the skills of their provider.
Best,
Mats Hagstrom MD

Jeffrey E. DeWeese, MD, FACS - Account Suspended · Answer

Unless your filler is encapsulated I doubt any is still present 8 years later! In my experience I haven't had any problems having fat grafts take in the faces of patients who have had hyaluaronic acid fillers. The Coleman technique (very small aliquots of fat each placed in its own tunnel) is still the best approach to fat grafting in the face for maximal take, still up to 40% of the graft can be resorbed. Good luck, Jeffrey DeWeese, MD, FACS

Could lingering Juvederm affect fat graft getting blood supply to nasolabial folds?

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Could lingering Juvederm affect fat graft getting blood supply to nasolabial folds?

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Everything you need to know about Facial Fat Transfer

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