What are the pros and cons of temporal implants vs. fat grafting?

Question

I'll be having a coronal incision for another procedure so the implants could be easily placed under the muscle. Otherwise, I would have fat grafted to the area at a later time. I'm concerned about headaches, possible visibility or palpability of the implant, and the unpredictability of fat.

Yannis Alexandrides, MD, FACS · Answer

Temporal implants are not my first preference for improving temporal concavities. I believe fat grafting is far more superior because it's safer and it's easier to correct asymmetries between the two sides. Temporal implants have the potential for infection and extrusion, and at times can be unnatural looking too. On the other hand, with fat grafting, the patient may experience fat re-absorption or lumpiness.

Carolina Restrepo, MD · Answer

Thanks for your question. Fat transfer to the breast has become more popular in the press, but we do not perform this procedure as we do not believe that it has been properly proven as a safe, dependable, and cost effective means of performing breast augmentation.  There are also possible side effects that one must consider, including the risk of scarring on a mammogram that can complicate detection of breast cancer.  Other side effects are possible infection, fat resorption necessitating more sessions of fat grafting, and possible asymmetry. 
 Implant based breast augmentation, on the other hand, is very safe and predictable with an extremely high patient satisfaction rating in our practice.  Fat grafting is best for breast contour irregularities.  Very large amounts of fat and possible multiple sessions would be needed to approximate the result of large breast implants for breast augmentation.

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question.  One of the best facial rejuvenation treatments is the addition of volume through the use of a patient’s own tissues.  Fat grafting provides soft, supple results that can be tailored to each patient with little risk of infection, malposition, or palpability that accompanies a solid silicone implant.  Hope this helps.

Ronald J. Edelson, MD · Answer

I share your concerns.  I seriously doubt either procedure will work well enough to be worthwhile st all. Just stick with the coronal lift.  The other procedures are losers.

Robert M. Tornambe, MD · Answer

sgny  I appreciate your concern, however fat grafting to the face has proven to be able reliable and useful procedure. Facial Implants can become displaced, causing a weird look and can bring other issues. The only fault of fat grafting is predictability of take of the graft, however studies demonstrate that at least 30% to 50% of fat grafted to the face takes permanently. Discuss all pros and cons with your board-certified plastic surgeon. Good luck.

Stephen M. Davis, MD, FACS · Answer

Thanks for writing,Other have cover to pros and cons quite nicely. Fat is soft, supple and it is your own tissue. With implants; migration, turning, palpability, distortion, pain  are much more of a problem. With fat it may require a staged procedure as not all the fat grafted survives. Good luckStephen M. Davis, MD, FACS
Certified: American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery
Member: American Society of Plastic Surgeons
Member: RealSelf Hall of Fame
VERIFIED: Plastic Surgeon

William H. Sabbagh, MD · Answer

Hi Sony, most surgeons will prefer fat grafting over facial implants.  There are many nuisance complications associated with implants such as malposition palpability visible edges and pain.  If they nneed to be removed they can leave a soft tissue deformity that can be hard to correct. The main negative of fat grafting is resorption and additional grafting can always be done if needed.

What are the pros and cons of temporal implants vs. fat grafting?

Answers (7)

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