Structural fat grafting can provide very natural looking results. The natural results are not the results we see. When expertly performed, people don't look like they have had surgery. Instead, they just look great and natural. Fat grafting has gained popularity and some physicians without proper training or instrumentation are performing fat grafting with results that look distorted, overfilled and unnatural.
Realself is a great place to start. Look at before and after images and videos to find fat grafting surgeons with results that appeal to you. Then carefully check the credentials and education any surgeon you are considering.
Facial Fat Grafting is a process of transferring living fat cells from one part of the body to another in order to create volume changes which effect facial contour and appearance. When done well, they should be virtually indistingquishable from facial tissues which have not been grafted, but the results are almost completely dependent on the technique, skill, and artistic vision of the surgeon doing the grafting. Certainly fat grafting is far more "natural" than having large amounts of filler injected in order to change facial contour, but fat grafting can also result in a highly unnatural appearance and/or with visible irregularities if not done properly.
Of all the modalities to restore facial fullness lost with time and sun exposure, fat is by definition the most natural. Anecdotally, some will even attest to certain "trophic" qualities of fat causing the skin to appear smoother and more glowing. As with all plastic surgery procedures, however, the results are dependent on the judgment and skill of the practitioner, someone who is a board certified plastic surgeon with experience in fat grafting. Judicious use of fat is mandated as fat is ultimately permanent. As it is expected that some volume will naturally atrophy, I tell patients to expect half the volume to survive after each procedure and plan a staged approach where more fat can be added over two to three procedures. This ensures against over-filling - which would indeed cause an unnatural outcome - and limits complications. If well done, people will comment that you appear "well-rested" or that you look "healthier" - not "plastic."
Plastic surgeons have become more accepting of fat grafting as a very viable option for restoring volume to the face, breast and body. As with anything else the longer we have had to perfect a technique and to learn from our mistakes the better we can become. Fat transfers to the face is a very good example of this. The industry as a whole has had more experience with fat transfers to the face than to any other part of the body. As such more plastic surgeons perform fat transfers to the face and have had more experience using it for the face than to any other part of the body, and we have gotten much better results with fat grafting than we did when we first started doing it over 2 decades ago. But with any specialty procedure, not every surgeon has the same experience or uses the same technique. Careful harvesting and preparation of the fat is key to minimize trauma and to optimally purify the fat cells for slow, careful placement of the fat in small aliquots at a time (using microcannulas) in a triangulated pattern in varying depths of the tissues will ensure more graft survivability. The less fat that does not survive, the less nodularity and palpability you will have. Viable transplanted fat will feel as natural as the native fat of your face. That's the beauty of fat transfers. I would recommend you seek consultations from board certified plastic surgeons who have a lot of experience with fat transfers and can show you a lot of great before and after pics with good follow up. Best wishes.
I love results of fat grafting when its done well. I suggest soemone who uses water assisted harvesting without centrifugation and with adding PRP. Best, Dr. Emer.
The main factor is the technique and experience of the surgeon. Knowing what aesthetic beauty is all about and how to do the procedure well for that patient. I have been doing this procedure after training at UCLA and further subspecialized in it 14 years ago at the world renowned Ivo Pitanguy clinic in Brazil. So experience is key.
The answer to your question depends on the skill of the operating surgeon, the amount of grafting done, and the goal of the procedure. After doing fat grafting for 30 years I feel that natural results can be achieved with good technique.
That's a very good question. I use fat grafts in conjunction with all of my face lift procedures to restore volume and rejuvenate skin texture. In 15+ years (or more) I have never seen an irregularity, bump or depression caused by fat grafting. The ONLY patient I have ever seen whose face felt very unusual (but looked very good) was a woman who had had multiple fat graft sessions from a well respected surgeon in order to avoid a much need facelift. The thickness of her tissues was very abnormal in my opinion but of course this is avoidable.
With most fat graft procedures (perhaps all) it is very difficult to determine whether any fat has been added. It's IMO more natural feeling than fillers.
Hope that this helps. Best wishes,
Jon A Perlman MD FACS
Certified, Am Board of Plastic Surgery
Member, Am. Society for Aesthetic Plastic Surgery (ASAPS)
Beverly Hills, Ca
Thank you for the question and the assumption is that fat grafting is performed to enhance ones appearance not make obvious changes
I'm trying to think of a good analogy for your question.
Perhaps it's like saying how spicy is Indian food.
The rice and yogurt have zero spice but other dishes can burn your head off.
Facial fat transfer runs the gamut of seeing no noticeable change at all to a complete transformation and at worst grotesque disfigurement.
i'm not sure if that helps but the question is a little too vague to give an accurate answer.
Mats Hagstrom M.D.