Is 50 cc of fat mixed with growth factor(mixed with my own blood) is enough or too much for the cheeks area? (Photo)

Question

Is 50 cc of fat mixed with growth factor(mixed with my own blood) is enough or too much for the cheeks area? I have deflated cheecks. the doctor said he can inject the fat from a site next to the ear and sculpt it into upper cheecks area. I am worried that will look fake or the chipmunk look

Jason Emer, MD · Answer

This needs an in-person evaluation. Keep in mind, not all fat will survive fat transfer. Fat transfer technique is important for successful fat transfer. I recommend water-assisted fat harvesting which gives pure fat to transfer and combine with platelet rich plasma (PRP) to get the most viable and sustainable fat cells. I combine with Sculptra, depending on the area, to improve final results. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

John J. Martin, Jr., MD · Answer

50cc of fat is quite a bit to inject into the cheeks.  Even though about 50% may resorb, that would be a lot.  We might inject 50 cc if doing the whole face: cheeks, temples, jawline, NLF etc. But 50 just for the cheek may make you look overcorrected.

Robert Brueck, MD · Answer

This is really a judgement call and I probably would not inject that much especially if it just to the malar areas but agin every one has their own opinion'

Mats Hagstrom, MD (license on probation) · Answer

The amount of fat to be used as a very subjective one. I personally would never predetermine how much fat to inject.    My personal approach is to inject in the fat to get the desired results. I then calculate what I believe will be the percentage of fat that will not survive from there over treat with the hope that the final result will be the desired one.  For example in a young person with substantial volumes to inject into I may add 1/3 more than the ideal volume. If someone a little older with not as much tissue to inject into I may double the volume.  I will generally tell my patients it’s better to slightly under treat and plan on doing a second session that it is to overtrade.
 There may be some scientific truth to using growth factors. I still think it’s a little bit of voo doo medicine.  Hands-down technical and aesthetic skills win when it comes to facial fat transfer.  Nothing wrong with adding growth factors other than having to have blood drawn and potential extra costs( money and the doctors pocket?) sorry for my cynicism.

50 mL of fat sounds like a reasonable amount for a facial fat transfer procedure but much of it depends on how diffuse or what  areas are being injected. Most people who do facial fat transfer well blend the fat into the surrounding areas to not create a bulge or what you call chipmunk cheeks. If all 50 mL a pure fat is injected just into the cheek that it sounds excessive. 
 I personally have gotten away from doing facial fat transfer procedures because of the finicky nature and challenge and maintaining overall high patient satisfaction.  I still do them from time to time. You look a good candidate for the procedure. The key is selecting the correct provider. 
. Best,
 Mats Hagstrom MD

Val Lambros, MD, FACS (retired) · Answer

You look young and very pretty. Though I could imagine a few cc of filler like voluma, based on the picture and more than 25 years of fat grafting experience, IMO 50 cc of fat is way too much both as an aesthetic result and for the future.  You may gain weight with kids, or just with life. That fat will likely grow and look huge and is difficult to get out. It is a good idea not to do things that you can't undo if necessary.

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