I am concerned about the long-term results of fat transfer to the face. Is it really permanent?

Fat grafting results and longevity depends on surgeon's technique and the quality of fat that is harvested. Addition of PRP which is enriched with growth factors will help survival of grafted fat. I have written a paper in 2005 reviewing 500 patients using PRP with fat grafting. 

This is a great question. The reason you are feeling confused and that there is controversy is because there are academic and stimulated disputes about the percentage of fat that survives, the best way to transfer fat to maximize results and how long the outcomes will last amongst surgeons. 

The truthful answer is that fat survival is variable in many ways. As I mentioned about the harvest technique, dilution technique, layer of application, blood supply and patient health status are just a few of the variables involved in the success of this procedure. 

My recommendation is to talk to as many people as possible that have had the procedure (this site is great for that exposure) and meet with a few different surgeons to get a feel of what they can offer you. 

In my hands fat grafting is one of the most satisfying procedures we perform. Patients are happy, the results can be dramatic and it is a great adjunct to many of the other procedures we perform. Skin texture improves, facia volume improves, and the transition from facial subunits can become harmonous. This is all extremely beneficial. 

My discussion with patients goes something like this, "Fat take rate can vary. Clinical studies show fat survival ranging from 20-60% in variable locations. I average that out (~40%) when deciding how much and where to inject. An important point is that this results in a slightly overdone look for the first month because I need to inject 10mL for every 4mL I wish to be permanent and use to contour and mold the face."

Every patient is different, each subsite has a different blood supply. Whether the fat is placed deep or superficial to the  muscle makes a difference. All of these many different variables come into play and cloud the picture of permanent vs. temporary in the sense of how we think about synthetic fillers. 

Best of luck,

DrC

If the fat is there at 6-12 weeks it stays forever and functions similar to fat where it came from.  I suggest PRP/sculptra post fat transfer to maintain the results.  Best, Dr. Emer.

having done fat grafting for more than 35 years and been able to follow my patients  for that time I can tell you that approximately 50% of the fat will remain forever.  However, it depends on the experience of the surgeon and how the fat is harvested etc. I would not use a otherwise permanent filler since these are difficult to reverse. See a very experienced fat injector can show you excellent results but also discuss complications from this  surgery. 

Fat grafting can be permanent. There are many variables that determine the longevity of fat grafting. I would encourage you to start by viewing many, many before and after images and pay close attention to patients who have retained fat for six months, a year or more.Fat grafting being permanent can be a blessing or a curse. There is no way for a plastic surgeon to know exactly how much fat will be retained. This is why it is imperative never to over-correct.  Look at many, many photos as everyone has a different aesthetic ideal. I personally think people look odd and unnatural when their face is overfilled with fat. Truly, I think most patients with that result were hoping for something different. However, there pare people who desire a very, very full appearance. That is a procedure I simply do not perform. I would encourage a prospective fat grafting patient to look at many, many before and after results. if the after results posted by a plastic surgeon you are considering appear natural, and you are seeking a natural looking result, that is a good place to start. Also important to check on education, experience, record of safety, and the surgical environment and the surgical tea.

There is little remaining controversy among experienced plastic surgeons about the safety, long term effectiveness and value of fat grafting to the face.  There does remain disagreement on what is the best place to harvest fat, what instrumentation and methods have the greatest success.  Some areas of the face such as the tear trough area, along the orbital rims, there is an extremely high reliability of the fat.  Other areas such as the lips or depression areas around the mouth, called marionette lines, there is less predictability.  Clearly, fat grafting to the face is extremely valuable and one of the biggest advances in cosmetic plastic surgery in the past 20 years.  I hope you find this information helpful.

Although fat grafting or fat transfer is considered permanent, it responds just like normal fat in the body and will dissipate through natural aging. It is still a superior treatment for restoring volume vs hyaluronic acid fillers.

Thank you for posting your question. On average, half of the transferred fat will eventually be absorbed by the body. The remaining fat will act just like other fat cells in the body. For example, they will expand or shrink just like any other fat cells in your body in respond to change in weight. Best of luck.

When fat grafting is done properly, it will be permanent; in fact, I have had to remove some several years after placement as it grew too much; this is proof that fat grafting is a permanent solution rather than fillers which are temporary cures.

Thank you for the question and the fat transferred has to survive to be permanent.  If it doesn't then over time it will be lost but usually som percentage survives



Dr Corbin