I have done fat transfer for 25 years. I have patients who I have followed for many years, a few for up to 20 years. The grafted fat that's there at three months will last. But that does not stop the patient from getting older. I have never seen a late complication from fat unlike implants and synthetic injectables. Fat embolism is largely if not exclusively due to bad technique. Synthetic injections such as HA's, Scuptra are more likely to have embolism problems. The same is true for lumps and if an extremely rare one was to appear it would be very easy to treat.
Results are great when done well and long term there should be little to no risk, except for a cosmetic outcome that is either good or bad depending on the technique/take of the fat in the body. Best, Dr. Emer.
Dear katrinaGrafted fat that remains after 3-4 months is alive and will get larger or smaller depending on your overall body weight gain or loss. Facial fat grafting is not equally safe in all parts of the face. Injects for tear trough are at highest risk for longterm complications including bumpiness and overfilled areas. Due to its proximity to eyes, has no easy fix. Cheek and temple injections are safest.
Fat is living tissue and acts like the area from where it was taken, not like the fat where it's put in. I have been doing fat injections for more than 25 years and one learns things over a long time period that you don't discover if you just started doing it. The main LONG term risk is that it grows. This is usually related to gain in body weight. If fat was taken form the abdomen or hips or places that put on fat, the grafted fat will grow as well. This usually happens on youngish people who get fat and then have kids and get menopausal and put on weight, though I have seen I happen in a few people who didn't gain weight too. The increase in fat almost never looks good and is hard to remove, Almost never can you go back completely to what it used to look like. . For that reason I am VERY conservative about using fat in people less than about 45 or so. The immediate results can look great, but the long term, 5-20 years down the line can look terrible.
The procedure is relatively safe and practically speaking the major risk would be one of disappointment if only a small percentage of your fat survives. The benefits of course are restoration of volume and an often seen rejuvenation of the overlying skin presumed due to the presence of stem cells.
I avoid any injection of fat to the frown line area and to the forehead due to reports of partial or complete loss of vision which is obviously the scariest of risks. Assuming fat is injected into the appropriate areas of the face the risks of complications are extremely small. I do fat grafting with nearly all of my facelift procedures and in at least 10 years have never seen a complication from it. Be certain of course that your surgeon is experienced and knowledgeable in the appropriate technique.
Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California
If your facial fat transfer procedure is successful then it should carry no long-term complications risks.
Of the possible risks included for a facial fat transfer the most common by far is an undesirable aesthetic outcome.
Other potential problems involved could be facial nerve injuries or injuries to underlying structures such as the parotid gland.
Fat transfer around the eyes could potentially cause injuries to the eyeball itself which could at its worst lead to blindness.
Fortunately these complications are fairly rare.
Facial fat transfer can be unforgiving at times and I suggest you only let someone with proven expertise talent and experience do this procedure for you.
It is particularly challenging in thin areas around the eyes.
Mats Hagstrom M.D.