Always be careful as you select a surgeon as fat grafting, specifically fat grafting of the eye area requires specialized instrumentation, surgical expertise, experience and patience on the part of a surgeon. One way to get a sense of a surgepon's ability to provide permamnet results is to look at their before and after photos. Fat grafting has become very poular and physicians wihtout appropriate training and instrumentation are providing less than ideal result. View dozens of before and after photgraphs of fat grafting that are appealing to you before considering a fat grafting surgery. The survival of grafted fat is variable from procedure to procedure. As it is essentially impossible to quantify the survival of grafted fat as a percentage of the total amount of fat that was transferred, I instead tend to look at it in terms of what percentage of the overall improvement (that is seen early postoperatively) is still persistent at four months postop. If it's still there at four months, then it has a blood supply and will persist long-term. In my experience, most patients show a 50-80% persistence of the early improvement at four months. If less than 50% of the improvement has persisted, most patients need and want a secondary fat grafting procedure. We perform such fat grafting 'touchup' procedures at a significantly reduced cost compared to the initial procedure, and patients are advised of the potential expense before they have their initial surgery. Another way to look at this issue is to ask 'what percentage of patients require a secondary fat grafting procedure in order to get the result they are looking for?'. Because my approach to fat grafting is conservative, I have a fairly high number of patients who return for a second procedure. I would much prefer to have a patient like what they get and return for more, than to have a patient who is unhappy because they feel that their fatgrafting was overdone. If you look at reviews posted by fat grafting patients who have had a very negative experience with the procedure, you find an abundance of patients that feel that an excessive amount of fat was placed in their face. They're not just unhappy - they feel disfigured. So a conservative approach is absolutely critical to success with facial rejuvenation by means of structural fat grafting. To be worth a patient's time and money, fatgrafting needs to look natural, and not like a trip to the operating room.
