Will previous use of facial fillers affect the successful outcome for fat transfer procedures?

Will previous use of facial fillers (Radiesse, HA fillers ...etc) affect the success of facial fat transfer procedure? How long do you need to wait to get fat transfer?

Doctor Answers 6

Can Facial Fillers Affect Outcome of Fat Transfer?

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That's an insightful question and to answer it, it is important to understand how fat transfer works. The fat that is transferred is a living tissue graft. Live fat cells are taken from one place and put into a new location where they take up residence. In order for the fat cells to survive in their new environment they must be in contact with healthy tissue so they can acquire oxygen (from the circulating red blood cells) and nutrients. If the fat cell are not placed into this favorable environment some or all of those grafted fat cells will die. This is a big reason why their is variability in the "take" of fat grafts. 

So now let's look at happens when filler is placed into tissues. Fillers are non-living grafts that can replace lost volume and/or have an influence on the overlying skin structure. Most fillers work as a simple bulk volume replacement, but to differing extents, fillers also work by stimulating collagen production which accounts for varying degrees of the volume or filling effect. Some fillers re-absorb after months or years, others last indefinitely. The problem is that the collagen (scar) that is produce by the filler has a very poor blood supply. This means that any living fat graft that is put into an area where filler was previously used may not be getting placed into a favorable environment due to the diminished blood and nutrient  supply. Without those nutrients the fat graft will die and hence the percentage "take" will diminish. So yes, extensive use of fillers can result in a lesser outcome from fat grafting.

As others have pointed out, many fillers are fully resorbed after a couple of years but that is not true for all fillers. If a person has had a single round of filler placement it will likely have little effect, but some patients undergo multiple rounds of filler injection in the mistaken notion that the filler will "lift" their face. Fillers do not lift sagging facial tissues. They can replace lost volume which is a component of facial aging and therefore result in some measure of rejuvenation, but it is incomplete, and when overused, they can result in a very unnatural change. Unfortunately there are a large number on needle wielding non-surgeon providers who's only tool is to inject things into people's faces. When done judiciously the outcomes are beneficial, but when overdone the results not only look unnatural but they also compromise the potential of other procedures like fat grafting or a facelift to successfully achieve their purpose. 

Fat grafting after Fillers

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Many individuals opt for fat grafts after they have had fillers injections.  The amount of filler remaining and the planned fat grafting procedure require evaluation on a case by case basis to best determine the ideal timing. 

Warm regards,

Dr. Pedy Ganchi                                                                                                                                                         Village Plastic Surgery

Pedy Ganchi, MD
Ridgewood Plastic Surgeon
4.9 out of 5 stars 98 reviews

Fat After Fillers

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Use of fillers won't preclude a fat transfer or limit its success especially if the filler has been largely absorbed by the body. See an expert for a formal evaluation. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Hyaluronic Acid Filler

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It is common for many to start with hyaluronic acid fillers before choosing more permanent options such as fat transfer and Bellafill. Hyaluronic acid fillers such as Restylane and Juvederm are naturally absorbed by the human body in about two years. How long you should wait really depends on when your last filler injection was. I recommend meeting with an experienced, board certified physician to discuss your filler use history and specific goals.

Jan Zemplenyi, MD
Bellevue Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

Will previous use of facial fillers affect the successful outcome for fat transfer procedures?

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Thank you for your question. All HA filler products eventually resorb over time. Provided that you have given these products enough time to go away (sometimes up to 2 years with certain products), then they should not be around to have any contribution or detriment to a facial fat transfer procedure. Before proceeding with treatment, you should be open with your HA use history and let your surgeon exam the areas thoroughly. 

Best of luck!

Fat transfer after fillers to the face

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Prior injection of facial fillers, including HA and Radiesse, does not preclude fat transfer as long as the fillers have largely been reabsorbed. In general I would advise 18 to 24 months for HA fillers and Radiesse, but the anatomic areas of prior injection should be assessed in consultation with your surgeon first. Good luck!

Harrison C. Putman III, MD
Peoria Facial Plastic Surgeon
4.7 out of 5 stars 13 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.