Are fat transfer techniques improving so that fat lasts longer?

There is no doubt that experience of the surgeon with facial fat grafting has significant influence on final result. Selection of the patients, preparation and application of micro and nano fat grafts may be different from surgeon to surgeon. Major problem with fat grafts however, is unpredictability of graft take; an average survival of 30% of injected fat should be expected; individual variations can be expected even in the most experienced hands.

Fat transfer is a pretty specialized field. It's not really luck, but more like proper patient selection and technique. Of the fat that survives, it will be permanent. Knowing approximate retention rates in different parts of the face, as well as harvesting instruments and techniques, fat preparation, and injection method all play a role in the results.

There have been a lot of advances with fat grafting techniques including
Use of antioxidants and hyperbaric oxygen
Pre operative tissue expansion
Harvesting higher stromal vascular content
Micronization of fat grafts and nannofat
Combining fat with SVF which is obtained from the blood of the patient
Multiple layered injection including intradermal
Repeat injections