Is "live fill" a better choice than regular Fat Transfer? Can more fat be added if lost after the initial surgery?

Fat grafting is a great way to augment facial rejuvenation surgery. When performed appropriately, fat is a permanent solution to hollowing and volume loss related to aging. While many have branded a specific technique, there is no scientific evidence that one technique is superior to another. I personally tell my patients to expect about half of the fat to disappear over the first six to twelve months, but that the rest of it will be very long lasting if not permanent. For those needing a very significant amount of volumetric enhancement, I tell them to expect to need another fat grafting session six months after the first. Though fat grafting can be performed as a stand alone procedure, I personally perform the far majority of my fat grafting at the same time as other procedures like facelifts and blepharoplasties. I feel that fat is a great way to enhance the rejuvenation of surgery, and that fat alone is seldom the best way to give a client the BEST result.

Dear maggi5,There are differing techniques on fat transfer and you have to go with the person whom you think gets the best resultsAll fat that survives will be permanent, so the surgeon has to be careful with where the fat is placed, and how much of itWe do have certain systems which cleanse the fat so that only fat is left over, but again, it is the amount of fat that survives which is keyMore fat can be added over time, and if you have a very skinny face, touch ups after 6-9 months can occurIt is easy to correct if not enough fat was placed the first time, it is very difficult to remove fat if too much is injectedThe best way to go is to find the surgeon who can give you the results you are looking for and to have a discussion on what is expected from both sidesBest regards,Nima Shemirani

Regardless of the name and the technique, no doctor has yet figured out a method that can assure complete fat graft survival. Any claim to the contrary is not supported by scientific evidence and is more marketing than fact. The risk of every fat grafting procedure is that its retention is highly variable and not completely predictable. Fat grafts can be repeated endlessly until one runs out of donor material. The best fat grafting techniques employ concentration, micro-injection and possibly PRP supplementation.