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.