Which lasts longer; Filler or Fat Transfer? (photos)

ch910  A thorough consultation and examination is necessary to come up with an appropriate course of treatment.  First off, Juvederm , Restylane, Perlane, Radiesse which are all terrific fillers will not last more than 18 months.  My favorite filler long term safe, economical filler is Bellafill.  This filler has longevity and  can create beautiful contours.  Why rent your filler when you can own it?  Fat is a terrific filler but is extremely technique dependent.  I utilize the body jet system to harvest fat and mix it with PRP ( platelet rich plasma).  With this technique I get beautiful long lasting results.

There are permanent fillers available. I avoid them at all costs. filling  soft area with something hard doesn't make sense and will often lead to disaster. In my office we use quite a lot of JUvederm and Voluma, and fat grafting is one of the procedures I perform most frequently. So, the answer depend on your goals. Fat grafting is designed to be permeant. Other soft tissue fillers are temporary. An in -person, or photo consulttion might be helpful in determining what would be ideal for you. 

Fillers will be temporary ranging for 3 months of two years depending which type of filler and where it is injected. Fat transfer is a move invasive procedure but results are permanent. You seem like a good candidate for either. Consult with a board certified plastic surgeon for the best option for you. 

Fillers such as Juvederm only last approximately 6 months.Fat transfers can last permanently if they are done correctly and the fat develops a blood supply. Sometimes it takes two sessions with fat transfers to get the right amount of fat in the area, but whether it takes one or two sessions, you can get permanent results which for many is superior to the transient nature of fillers.I suggest a consultation with a board-certified plastic surgeon who can help you make the right decision.Good luck in your search and let us know if you have any further questions.

Fat transfers have the potential of lasting much longer than fillers if they survive the transfer process.  The fat survival unpredictability can be a disadvantage, especially if it is not done properly and in inexperienced hands.  Surgeons who have had a lot of experience with it and utilize good technique can usually achieve long- lasting and predictable results, as well as avoid lumpiness that can occur sometimes.  All the current FDA approved fillers eventually go away, and can last 6 months to 2 years, depending on which you choose.  They are quicker, easier, less risky and involve faster recovery than fat transfers.  For my own patients, for first timers, I usually recommend they try fillers first to see if they like the volume enhancement.  If they do and they don't want to come back in to have it repeated as often, I recommend that they consider fat transfers.  I would recommend that you only seek consultation from a board certified plastic surgeon who has a lot of experience doing fat transfers.  Best wishes.

The answer to your question is not as simple as "filler or fat transfer"To rephrase your question, filler versus fat transfer that is temporary vs fat transfer that is permanent(grafted and vascularized).Filler, temporary fat transfers or permanent fat grafting have different positves and negatives considerations.All three have the potential to be reversible, if desired.The unique feature of permanent(grafted)fat is the biological activity/growth factors of the fat cell in the face.Hope this helps

In general all fillers are temporary and depending on where they are injected last differing amounts of time.  For instance, restylane or juvederm in the lips may last only 6 months where as these same fillers placed in the under eye area can last several years.  The advantage of fillers are the minimal recovery involved, lower initial cost, no anesthesia required, reversibility for products like restylane or juvederm, and ability to really fine tune the result over repeated treatments.  Fat graft is a much more permanent options.  Some portion of the fat (around 50%) gets blood vessel ingrowth and becomes living tissue making it a semi-permanent filler.  Thus the advantage is longevity and the fact that you don't have to pay for the actual product since it comes from your body.  The down side is the recovery is longer and it usually requires surgery/anesthesia with higher upfront cost but probably less in the longrun.

I encourage all patients to use temporary fillers before embarking on a permanent volume restoration with fat grafting.Fillers are much more forgiving.Hyaloronic acid (HA) fillers like Juvéderm or Restylane can be reversed if something goes wrong.Fat transfer tends to work well for giving overall diffused volume enhancements. In my opinion, it is not as precise as fillers in areas such as nasolabial folds.Starting with fillers will give you a sense of what can be achieved, how much volume is needed in each area and if you like your provider's style.  Do realize these treatments can consume quite a bit of product. What you are describing can require several thousands of dollars' worth of filler.  Fat transfer is an attempt at a more permanent solution.  Best of luck,Mats Hagstrom, M.D.