Permanent Lumpiness After Autologous Fat Injection?

I am getting a face lift in December. The surgeon recommended autologous fat injections for nasolabial lines. I mentioned this to my dermatologist who strongly cautioned against autologous fat transfer. The derm claims with my fair Northern European skin, that fat, which is lumpy by nature, could yield uneven results. Both doctors have outstanding background & training and have primarily cosmetic practices. I am left wondering what to do. Advice/Input is appreciated. Thank you.

Doctor Answers 7

Fat Transfer with Facelift

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Hi Boston,

The vast majority of facelift surgeons use fat transfer with their face lift procedures.  Speak to your surgeon about your concerns, but I would lean toward the fat transfer.  As with anything that we do in facial plastic surgery, it is not the procedure but the skill of the person performing the procedure that will determine your results. Good luck and be well.


Dr. P

Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Lumpiness after fat injection

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I disagree with your dermatologist.  Perhaps he/she is an old-timer who remembers fat injections before more modern techniques of fat harvest and re-injection were developed.  Is there a risk of lumpiness?  Sure, but there are always risks with any procedure.  If done properly, with the right equipment, by a plastic surgeon experienced and comfortable with the techniques, it is a versatile, reliable, and effective technique.

Fat grafting to the face

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You're getting differing opinions from a dermatologist and a plastic surgeon regarding fat grafting. I would listen carefully to what both doctors have to say, but presumably it is the surgeon doing the fat grafting procedure (and the face lift) and not the dermatologist.

Fat grafting to the mid-face (malar and tear trough areas) is very effective. The technique is less useful in the peri-oral (nasal labial folds, lips) because of the movement in this part of the face. Grafts don't seem to last as long in the nasal labial folds. When done properly by an experienced surgeon fat grafting results can be smooth and soft.

Fat transfer

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fat transfers can cause lumps and irregularities but by injecting very small amounts and gentle message, it can be prevented. 

Christopher K. Livingston, MD
Houston Plastic Surgeon

Fat grafts during a facelift

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In addition to technique, fat graft results also depend on the location where the fat grafts are injected. For example, the nasolabial fold is much more forgiving that the lower eyelid so the results tend not to be lumpy. Placing fat grafts in the nasolabial fold during a facelift is common and has been done for many years.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 76 reviews


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Aging involves loss of fat, or volume and sagging . A face lift will lift parts and fat to where they belong. loss of volume is replaced by fat. Wen done correctly fat fraft is superior to any other filler.

Samir Shureih, MD
Baltimore Plastic Surgeon

Fat injections prior to facelift

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If fat is carefully placed in small aliquots in the deep subcutaneous plane and homogenously distributed then you might get a smooth result. If the fat is placed in larger volumes and more superficially then you could end up with a lumpy result. If the surgeon who recommends doing it has a great experience in doing this with people of your skin type, then you should trust their opinion since they have seen the results. Ask the surgeon, though, this question and they may say that you do have a risk of lumpiness. If they tell you it is a significant risk then you might not undergo the fat injection.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.