What is the Best Treatment for Fat Loss in the Face? (photo)

Question

which treatment is the best and longest lasting for replacing volume in the face? I have had Sculptra in the past and didn't really notice a great improvement. I am contemplating fat transfer as a longer lasting remedy. I have also had Radiesse and do like the results but it gets costly for the amount of volume I need replaced. Any suggestions? Also, does fat transfer leave you bruised and swollen a lot more than say the Sculptra or Radiesse?

Robert F. Centeno, MD, FACS · Answer

Fat transfer is the most cost effective treatment for restoring volume of the face. It is your own tissue and the most natural.  The stem cells in your fat anecdotally also seems to improve the health of your skin...the basis of the stem cell facelift craze.  The only downside to fat is more swelling and recovery than fillers.  Bruising is usually minimal using blunt cannula techniques.  Having said that you can usually go back to normal routines in under two weeks.  Seek consultation from a board certified plastic surgeon with considerable experience with this procedure. Check out the article link below outlining the pros and cons. Best wishes.

M. Scott Haydon, MD · Answer

This is certainly a hot topic in plastic surgery. Fat transfers offer the most noticeable volume but have a longer recovery. There is risk of having diminished uptake but with an experienced surgeon it should be fairly predictable. Sculptra has become very popular over the last few years. The onset is very gradual and you never have that "way too done" look. You do however have to have at least two injections. In looking at the photo you submitted, I would usually recommend 2 bottles on 2 occasions about a month apart. The product takes 6 months to peak and usually lasts a few years.

Sam Naficy, MD, FACS · Answer

You may be a good candidate for either Sculptra or fat grafting.  Both of these procedures are a good way to restore facial volume.

Donald B. Yoo, MD, FACS · Answer

As others have mentioned, the amount of Sculptra and the # of treatments may have been sub-therapeutic, thus explaining your lack of noticeable improvement.  When adequately treated, it does provide subtle but significant, and long-lasting volume correction.

	Fat grafting is also a great long-term option, although it is "surgical" because fat must be harvested from your body (liposuction).  Fat grafting does tend to leave you more bruised and swollen, and for a longer time, than any of the dermal fillers.

Michael I. Echavez, MD · Answer

All of the treatments you mentioned (Sculptra, Radiesse, fat transfer) would be options to replace volume in your face. Normally, the main reason you would not achieve improvement with Sculptra would be that not enough product was used or that you did not have enough treatments. The result with Sculptra should last two to four years, while the result with Radiesse would normally be gone by a year. Fat transfer results can vary and because it is more of a surgical procedure, I would say there definitely is more swelling and bruising than you would see with either Radiesse or Sculptra treatments.

Monika Soni, MD · Answer

Thank you for your question! A good alternative of Sculptra is Radiesse. It can make corrections like a filler and stimulate collagen growth like Sculptra. Most injectors use Radiesse as alternative of Sculptra to fill along the jawline, marionette lines, and cheeks. I recommend a consultation with an expert to determine the best treatment plan for you. Best of luck!

Craig Mezrow, MS, MD, FACS · Answer

Facial volume loss can be improved both with fat grafting as well as Sculptra. Sculptra will require multiple sessions and the number of treatments vary from patient to patient whereas, fat grafting may require one or two procedures.

Grant Stevens, MD · Answer

Sculptra is a great gradual volumizer.  Radiesse is also a good option but for instant filler results.  A lot of patients that desire a non surgical procedure do both for longer term and instant gratification..

	 

	Dr. Grant Stevens            Marina Plastic Surgery Associates          Marina del Rey, CA The Institute

Stephen M. Lazarus, MD · Answer

Hi Moni,

	Sculptra and fat injections are the two most common treatments for restoring facial volume. Both options have pros and cons. My preference is Sculptra/SculptraAesthetic (both are poly-L-lactic acid). 

	Depending on the age of the patient and the amount of volume loss, it may take 2-6 vials of Sculptra for optimal improvement which can last for two years or more.  A treatment session is one vial (sometimes two). Injections are spaced 3-6 weeks apart. You will see minimal improvement after only one vial.

	Thanks for your question and good luck!

Darryl J. Blinski, MD · Answer

If you liked Radiesse injections than in my opinion fat grafting with PRP would give you great results that would last longer and allow more volume filling for the same $'s. Yes there can/could be ecchymosis after the multiple injections.

What is the Best Treatment for Fat Loss in the Face? (photo)

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