What Are the Dangers of Fat Transfer to the Face?

Dear Neho

Thank you for your question!  Micro Fat transfer to the face is a complicated procedure.  If care is taken with the planning and the injections are done with skill, then very few complications will arise. The most common problem is under correction1 about 1 in 5 patients.  I use micro fat transfer for all facelifts, eyelid surgery as well as primary facial contouring and rejuvenation.

With Warm Regards,

Trevor M Born MD

The biggest risk which is extremely rare is embolization or having fat injected into a vessel, this can cause blindness or even stroke. Chance of that is extremely small and we have ways of reducing that risk as well

It is important to check your surgeon carefully. Fat grafting has recently become very popular, which means mamy doctors without much skill, exoerience, expertise or patience or performing fat grafting. The lack of techniques, and possibly proper instrumentation will not result in the best result.When you research fat grafting  online, you will widely varying opinions about fat grafting itself. There are surgeons, myself included, who think that fat grafting is safe, effective, and a critically important part of natural appearing facial rejuvenation surgery. There are other surgeons who think that it’s unnecessary, and there are even surgeons who think that it doesn’t work. The reality of fat grafting surgery is this: It requires, on the part of the surgeon, a significant investment of time and effort to become proficient at the technique. Once you are proficient, you as a surgeon find that 1) It is safe, 2) It is a scientifically sound and reproducible surgical technique, and most of all 3) Fat survives. Structural fat grafting creates a permanent enhancement of facial soft tissue volume. We understand now that the primary process of facial aging is atrophy. As we age, facial soft tissue atrophies. The facial skeleton even atrophies as we age. So, if you are facial rejuvenation surgeon, and you don’t perform structural fat grafting you are failing to treat the primary cause of facial aging, and I think that your results will show that. The best window a patient can get on a surgeons experience, and aesthetic sensibility with fat grafting is reviewing before and after photos. Go online and find a surgeon with lots of photos that show aesthetic enhancement that speak to you as beautiful and natural appearing.  

Over the last 5 years there has been a remarkable resurgence in fat injections being offered to patients to help "plump up" or volumize the face. The procedures are being done by facial plastic surgeons, general plastic surgeons and dermatologists throughout the world at an ever increasing rate. It is easy to do but not easy to do well.

Marketing for fat injections / transfers has also boomed as it will anytime a "new" and buzz worthy procedure appears on the marketplace. Some of this marketing is fair and accurate and others are well... marketing.

Various methods of doing fat injections have also emerged ranging from the older but effective techniques like using a syringe to harvest the fat, letting it settle out and then injecting it to new devices which will harvest and separate the fat while allowing for assisted injection techniques. There has also been recent interest and promotion of "stem cell" and fibrinogen assisted fat injections which while unproven do offer some promise (again remember though that there is always marketing at work when it comes to cosmetic surgery!).

As can be seen online the patient satisfaction with fat injections is variable - this is due to physicians offering the technique without proper experience or training, over hyping and overselling of what the procedure can truly offer patients and the simple realities that go along with transplanting living tissues - there will always be failures no matter what technique is used or who is doing it.

The complications of fat injection include infection, fat graft failure, calcification of fat (causes hard lumps), excess fat injection causing a "puffy" face, need for repeat injections and harvesting, infection of bleeding at the harvest site (belly, thighs or arms) and unnatural results. The most devastating danger would be fat embolism where fat particles are injected into a blood vessel and the fat travels to another area causing blindness or possibly death. Luckily this is extremely rare and an experienced surgeon will have the ability to avoid this.

The largest amount of complications occur when fat is injected to the lower eye area. It is crucial that a conservative approach is used and the surgeon understands the anatomy extremely well.

The key is to work with a surgeon who will be honest about what fat transfer can do for you and who knows how to do it properly in order to get the best results possible.

Fat injections will start to come back down to reality but will always remain a good technique for patients seeking facial rejuvenation when done properly.

Take care,

Dr. J

You need proper evaluation to determine if pure fat transfer is the right procedure for you. thee can be asymmetry, fat graft loss after this procedure 

Like any other fat transfer surgery, fat transfer to the face has certain risks associated. Although these risks are very rare they can occur. These include, infection, no take of the graft, partial take of the graft, asymmetry, swelling , bruising, absorption of the fat, putting too much or too little fat.  Fat transfer to the face is a very delicate, artful surgery. It is surgeon dependent and experience dependent. However when done right it can give amazing results and restore lost volume and reverse aging in the face.

As mentioned by other doctors fat embolization, infection, fat necrosis are some of the dangers. Other risk factors include lumpiness and hypertrophy of grafted fat.

There are a few conventional risks, such as infection, to facial fat transfer.  The most unpredictable part of the procedure is to take of the fat.  This, however, can be markedly improved with the technique used.  Even then up to 30-40% of the fat resorbs.  This must be taken into account when doing the procedure.  The face is different than other areas of the body.  There are multiple connections between the skin and the deeper tissues.  These connections must be understood to prevent problems.  Different areas also accept fat differently.  This, also, must be totally understood.  Therefore, the biggest danger in facial fat transfer is selecting the wrong physician to perform it.  In order to get a good result any to choose someone with significant experience in injecting fat as well as other fillers into the face.  Checkout ExpertInjector.com and the American Society for Aesthetic Plastic Surgery website.