Dermal Fillers Or Facial Fat Transfer? (For Temples And Lips) (Photo)

Question

Hello. I am 20, female, around 100 lbs and 5'2. I am looking into getting a septorhinoplasty soon.I am from New Jersey and plan to get lip piercings in the future. I also wanted to add volume to my temples and lips, and maybe even the pre-jowl sulcus. I was wondering what may be best in my case, and what I should go with. Should I do facial fat transfer or dermal fillets to the temples and lips? I have had a consultation for the nose, and am not sure if I can add fat grafting as an addition to the nose surgery after already having the consultation. If not, I may just go with filler. However, my mother does not want me to go with filler. I do not wants lumps or migration, is there any way to fix fat grafting or filler if it goes wrong? Thank you.

Zoran Potparic, MD · Answer

That is a very interesting question. I prefer fat grafts for most facial volume deficiencies except lips. For that reason, I would consider fat grafts for temples and use it for lip augmentation at the same time since fat is available. However, in my experience, take of fat grafts in lips is around 10-15% and for that reason I use Juvaderm as a lip filler routinely. Fat grafting can be done in the same time as rhinoplasty providing that your surgeon is familiar with technique. I hope this helps.

Anna Chacon, MD, FAAD · Answer

At 20, I would take a conservative approach and focus on your natural facial proportions before deciding on either fillers or fat transfer. It's understandable to want to address several areas at once, especially when you're already planning a septorhinoplasty, but it's worth separating what you truly need from what is simply an aesthetic preference.

Dermal fillers are less invasive and allow for more controlled, gradual volume adjustments. Hyaluronic acid fillers are particularly useful because they can often be dissolved with hyaluronidase if the result is unsatisfactory. However, they aren't risk-free. Lumps, asymmetry, migration, and, rarely, vascular occlusion can occur. Temple injections require particular caution because of the area's complex blood supply and the potential for serious complications.

Fat transfer uses your own fat, harvested from another area of your body. It can provide longer-lasting volume, but some of the transferred fat may be reabsorbed unpredictably, so the final result can be difficult to control. Lumps, fat necrosis, cysts, and contour irregularities are possible. Unlike hyaluronic acid filler, transferred fat cannot simply be dissolved with an injection if you dislike the result; correction may require additional procedures or surgery.

For the temples, the best choice depends on whether you have genuine volume loss and how much correction is needed. Both approaches have advantages and limitations, but temple fat transfer is still a procedure with important risks and should only be performed by an experienced, appropriately qualified surgeon.

For the lips, I would be especially cautious about permanent or long-lasting changes if you're considering lip piercings in the future. Piercings can introduce infection and cause local irritation or scarring. It's sensible to plan these procedures carefully rather than having everything done at once. If you choose filler, a conservative amount of hyaluronic acid filler offers more flexibility than fat transfer.

For the pre-jowl sulcus, treatment depends on your underlying chin and jaw anatomy, skin quality, and whether there is an actual volume deficit. At 20, I wouldn't automatically recommend filling this area without establishing why the indentation is present.

Regarding your upcoming septorhinoplasty, you can ask your surgeon whether combining procedures is appropriate, but adding fat grafting may change the operative plan, risks, recovery, and cost. It is not necessarily better to combine everything in one session.

Ultimately, neither filler nor fat transfer is completely reversible or guaranteed to be lump-free. Hyaluronic acid filler has the advantage of being dissolvable in many situations, but complications can still require urgent treatment. Fat transfer can be more difficult to correct if the result is uneven.

My recommendation would be to prioritize your septorhinoplasty, allow yourself time to heal, and reassess your facial balance afterward. Especially at your age, a staged, conservative approach gives you more control and helps avoid making several permanent or difficult-to-reverse changes before you know how the overall result will look.

Randal Haworth, MD, FACS · Answer

At 20 and slim, the first question is what each area actually needs, because the temples, the lips and the pre-jowl sulcus behave differently. Fat can add soft, natural-feeling volume to the temples and pre-jowl area, but part of the graft may not persist, a very lean person may have little fat to harvest, and an irregularity from fat is harder to undo. Hyaluronic acid filler is temporary and dissolvable, a real safety margin while your face is still maturing. Lips are often less a volume problem than a shape problem, so more of either may not give the look you want. Fat grafting is sometimes done at the same sitting as a septorhinoplasty; that is a planning conversation with your nasal surgeon. An in-person evaluation with a board-certified facial plastic surgeon who grafts fat regularly is the sensible next step.

Mert Demirel, MD · Answer

Filler and fat transfer both add volume, but they differ most in one thing: what you can undo. Hyaluronic acid filler can be dissolved with an enzyme if you do not like it, while fat that has settled in place cannot be dissolved, and correcting it later means removing it, usually with small liposuction or a surgical touch-up. For a 20-year-old who is worried about lumps and migration, that matters more than which one is "better".
For the temples, both are used. Filler gives a quick, adjustable result and is usually placed deep, which keeps it smooth. Fat transfer is more durable in the temples and can feel more natural, but only part of the transferred fat survives, so the final volume is hard to predict and some people need a second session.
For the lips, filler is usually the easier and more precise choice. Fat in the lips is less predictable, because the lip moves constantly and the graft can end up uneven or bumpy. The pre-jowl area follows the same logic as the temples, with the added point that you are not trying to add much there.
Yes, fat grafting can usually be added to a septorhinoplasty, and surgeons often combine the two in a single session, since fat is taken from the abdomen or thighs under the same anaesthetic. Having had a consultation for the nose does not prevent this. It only means you ask your surgeon whether they do it, and whether it fits the length of the operation.
If your mother prefers not to use filler, that is a valid view to take into account, but the decision should rest on your anatomy and on the reversibility you want. A reasonable plan for someone cautious is to do the nose first, let the swelling settle, and then decide on volume with a clearer picture of your face.
I cannot choose between the two from one photo of the lower face. A consultation to look at your facial structure from different angles and your skin will answer it.
Before choosing, it is worth asking your injector or surgeon how they would handle a lump or an uneven result in each option, and how many cases like yours they have treated.

Dermal Fillers Or Facial Fat Transfer? (For Temples And Lips) (Photo)

Answers (4)

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