After fat transfer cooling and gentle compression can help with swelling and to a very small amount, possibly fat survival. While theoretically reduced temperature may decrease metabolic demand of the fat trying to re-establish blood supply, the pressure that putting on the cooling can have a greater likelihood or causing problems of too much pressure, and actually keep out existing or new blood vessels. There is now scientific evidence that cooling with ice packs can increase fat survival, and done incorrectly it can even cause frostbite. We use hyperbaric oxygen therapy (HBOT) where we can get oxygen into the plasma which is the watery part of the blood, and that can bring oxygen to areas where there is little blood supply such as in fat where fat grafting is placed in the face. I believe that we are getting 10-20% better survival with this modality combined with tried and true methods, such as correct placement of very small packages of fat that has been properly prepared, and injected with small side port cannulas. In using fat grafting since 1988, with these techniques, I have seen up to 70% fat survival. In general I usually place fat twice in the face in order to get the look most of my patients desire