Fillers mix with fat graft - Does that mean I should not top off with fillers after fat graft as touchup?

Question

My fat graft doctor told me that I need to have fillers dissolved prior to facial fat graft or it can cause infections. Any information on that? What if the fillers won't be completely dissolved? Does that mean I should not top off with fillers after fat graft as touchup? Thanks.

John Reilly, MD, FACS · Answer

Hello, the sequence is important as they are different from one another. If you have foreign material in the fat layers of your face such as fillers adding fat that has been outside the body can bring bacteria into that area and foreign substances have trouble clearing themselves of infection and so this is not advised. You can remove the filler, depending on what type it was, with an injection which will cause that filler to dissolve. You can also wait and allow it to dissolve on its own. Once you have fat in place after a fat transfer, this is healthy tissue of your own and therefore does not act as a foreign body. It is similar to the fat that was originally in your cheek. Adding filler at that point only adds the small risk with any filler injection and that risk is very small in regards to infection. Best of luck.

John L. Burns Jr., MD · Answer

only hyaluronic acid fillers can be dissolved.  If you have a filer like Radiesse or Bellafil then those can't be dissolved.  Injecting fat on top of filler is common practice and should not be an infection risk.

Mats Hagstrom, MD (license on probation) · Answer

I don’t think there is any documented evidence that having fillers causes an increased risk of having infections. Each provider will have their own view on how to do things. It’s not uncommon for providers to prefer patients not have fillers in their face prior to doing fat transfer. Mostly so they can get a good assessment of what the baseline unadulterated face looks like.
Fillers after the fat transfer is something you’ll need to ask your provider about since each provider has their own view. Personally, I would not be too concerned about infections, but that it’s all in my opinion.
Infection rates are pretty low for most facial procedures. The chance of developing infection will go down with time so at some point it should not be an issue I would think but that’s always ask your provider. Best,
Mats Hagstrom, MD

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