Can fat be transferred to the same area of face where hyaluronic acid was previously injected?

Question

As a candidate for facial fat transfer (pre-jowl area and along the mandibular angle), I´m wondering whether fat cells and Juvederm voluma can coexist in the same skin layer without the risk for infection?? Also, my doctor told me that only 30-40% of fat will survive(?!) Is that true???

Frank P. Fechner, MD · Answer

It is not optimal to graft fat into the same areas where fillers have been placed beforehand. Often though, fat is injected into deeper facial layer and interference with fillers are minimal. Other times I will recommend dissolving hyaluronic acid fillers such as Restylane or Voluma a couple of weeks before the fat injection treatment. This is routinely the case for the under eye region (tear troughs).

Young R. Cho, MD, PhD · Answer

I often use dermal fillers to show patients what volume can do to help restore a more youthful appearance.  When they are looking for a surgical option, I offer them fat grafting which can be injected into the same areas as the dermal fillers.

Yuly Gorodisky, DO, FACOS · Answer

The fat and fillers may coexist in the same space.  There is always a risk with surgical procedures, but having had fillers in the area, should not make it any more than if you had not.   When the filler disappears the area may need more fat to be added to return to the fill that was achieved before.  It is true that a lot of the fat will disappear after the injection.  Not only that, you are usually swollen after the injection so the area looks much larger.  Some doctors use techniques to the fat to help it survive better, but usually a lot of the initial results disappear over  3 months after surgery.  30-40% is an honest estimate, sometimes it may be 50% or rarely more.  Additional fat transfer procedures may be necessary.

Hannah Vargas, MD · Answer

Yes, the filler certainly won't hurt the fat.  The only issue for the surgeon is being able to determine how much volume of fat is needed.    If the same surgeon is doing both procedures then it shouldn't be much a problem.  Another option is using hyaluronidase.  This is a simple injection that would dissolve the filler. In terms of the fat grafting yes only about 30- 40% will survive.  We never know which patients will have the highest take.  That is one negative about the fat grafting.  On the other hand, some percentage of the fat will survive and likely be permenant.  And that can be a beautiful thing!  Discuss further with your surgeon.  Good luck!

Timothy R. Miller, MD · Answer

Yes.Transferred fat and hyaluronic acid (HA) filler can co-exist in the same areas.  If you have an HA filler in an area and you are going to transfer fat into that area, you can have the HA filler dissolved prior to the procedure.  This will allow the surgeon to know what "true" volume you have or don't have in the area, so he/she can more precisely transfer the correct amount of fat into the area.  Usually the HA filer is dissolved 2 weeks prior.I hope this helps.

John J. Martin, Jr., MD · Answer

You can add fat to an area with previous fillers.  Since the area is already somewhat filled, you may not get as reliable a fill with the fat since the HA is going to slowly dissolve as will some of the fat.  So good idea is to wait until most of the HA gone.  usually about 50% of the fat will remain.

Dilip D. Madnani, MD, FACS · Answer

Yes it can, it depends on exactly when the voluma was done, for example, I wouldn't do fat transfer to your face if you had Voluma done yesterday, but I would do fat transfer even if you have had fillers in your face for a few weeks/months or longer. It would all depend if you had any residual effects from the Voluma injections.With regards to the fat transfer, you can expect about half of the inserted fat to stay, so I typically put more than you need. After about 7-10 days it looks pretty good, even though you are still swollen and then over the next few months, the transferred fat regresses a bit (gets skinny), while it getting used to its new home (the recipient areas on the face). After a few more months, the fat gets fuller and those results will stay for a very long time. (See my pictures on my website)The second benefit you will see from the fat transfer is the theoretical 'stem-cell effect'- where you will also see an improvement in the overlying skin tone and texture.  Email me if you have more questions. Good Luck.

Can fat be transferred to the same area of face where hyaluronic acid was previously injected?

Answers (7)

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