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.