Would facial fat transfer benefit me? What exact procedures would you recommend for facial contouring? (Photo)

Hi Thoughtful,
I would not recommend facial fat transfer in your young face. There is too much risk of asymmetry and possible fat hypertrophy as you get older and gain weight. Instead I would treat you with strategically placed Sculptra which is much more predictable than fat. You may have botox injections into your masseter muscles to help narrow the lower third of your face. Choose your treating physician most carefully. Good luck and be well.
Michael Persky, MD
Encino, CA

​Volume and contouring of the cheeks can be created with well-placed fillers (Voluma, Radiesse, Bellafill) and Sculptra. Implants or fat are alternatives. Botox and radiofrequency can help slim and contour the jawline. Liposuction can help slim the face. Ultherapy, J Plasma and RF treatments can provide skin tightening and lift. I would recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer​

Thank you for the photos. You have what is considered negative vector facial morphology, making you correct thinking that your malar area is not (sufficiently) projected -- at least according to aesthetic ideals. Fat transfer to the malar area and periorbital area would be a good choice to modify your facila architecture.

Thank you for your question. Contouring is all about managing proportions, as well as light and shadow. Instead of adding volume to the upper face, what would you think about slimming the lower face? Buccal fat pad removal is a relatively minor procedure that uses incisions in the mouth to remove some of the fat in the cheeks, which in turn creates a more defined facial appearance. This would reduce the risk of having your cheeks appear overly prominent as well. I hope this helps, and all the best.
-Dr. P

Great series of posted photos! I agree nano & micro fat grafting to malar areas for more rounded projection would improve your appearance. Fee $5,000 ranges. Best to virtual consult with...

Augmentation of the midface can be done in many ways. Traditionally it was done using implants. In the 1990s the mid facelift was popular. When HA fillers hit the market in the 1990s experience with facial volume augmentation exploded. Likewise those working with that transferred also followed suit.
The bottle of these options working with fillers is in my opinion your best option. That transfer in comparison the filler is emprecise unpredictable and unforgiving. It’s simply a difficult procedure to do well consistently and fillers are completely the opposite.
That doesn’t mean that anyone can get good results with Fillers but it’s far easier and if something goes wrong with Fillers they can be reversed or you simply wait it out.
If you don’t like the results from fat grafting you’re in trouble because removing grafted fat in the mid phase is very difficult.
To get an idea of what can be achieved with fillers I suggest looking at Dr. David Mabrie’s website in San Francisco.
He is a facial plastic surgeon who only works using facial fillers.
We all understand the desire to have a permanent solution but you need to recognize that if you opt for a fat transfer results may not be what you hope for and if it’s not it’s very difficult to reverse the decision.
If you choose fat transfer then you need to find the most talented an experienced provider in your community for the procedure.
Doing that isn’t easy and it cannot be accomplished thing a computer.
It requires having a lot of in person consultations.
During each consultation ask each provider to show their entire collection of before and after pictures for midface fat grafting results.
You need to make absolutely sure that all after pictures were taken at least three months from the date of the procedure. Early fat transfer results can look very impressive but do not ever represent what the final results look like.
And experience provider should be able to show you a minimum of 50 sets of before and after pictures for the procedure you’re interested in.
Highly experienced providers will have hundreds or even thousands.
Simply seeing a handful of selected sample pictures which most likely represent the best results of the providers career is insufficient that a clear understanding on with average results look like in the hands of each provider.
This is why patients need to properly that plastic surgeons during consultations and push them to open up their portfolio and show their entire collection for at least as many pictures as you’re willing to show you. This is why patients need to properly that plastic surgeons during consultations and push them to open up their portfolio and show their entire collection for at least as many pictures as you’re willing to show you. This is one of the ways you should be deciding who should be doing the procedure and you should let providers know that your decision will be based in part and who has the greatest number of quality pictures they’re willing to show you.
As provider specifically to show you examples of excellent top comes, average outcomes unless than outcomes.
Ask them about what happened to patient who weren’t happy with the outcome, how many patients have been unhappy, how many patient required revisions including removal of previously grafted fat.
If possible ask them to show you pictures of what those patients results look like.
Finally I recommend reading all the reviews on various physician review websites avoiding providers with any substantial number of justified negative reviews. The absence of justified negative reviews is more important and more telling an abundance of positive.
Continue having consultations until you feel quite comfortable you found the most talented and experienced provider in your community.
Whenever possible avoid virtual consultations and meet with the provider in person.
My recommendations if patients avoid facial fat grafting especially if you’ve never had any treatment before. Fillers are so much superior to fat in terms of consistency and quality results but especially what happens if someone doesn’t like the outcome.
Good luck,
Mats Hagstrom, MD