If I don’t like the result of the fat transfer, can it be corrected?

Question

I can see that most doctors recommend fat transfer over fillers for mid face. I know if I don’t like the result of the fillers it can be removed but I’m not sure what if I don’t like the result of the fat transfer, can it be corrected?

Philip S. Schoenfeld, MD, FACS · Answer

My suggestion is that you have filler placed by someone who also does fat grafting and even mid face lifting.  Now you have a situation where everything does not "look like a nail" and you will get the best option available and  not the only option available.  If you have never had any mid face filler you should try this first.  If you like the appearance of the filler, perhaps over the course of a year or two, then you will likely appreciate the appearance of fat even more.  Your surgeon can be conservative but some transient over filling can be expected.  Fat grafting techniques are more precise with better predictable outcomes than it used to be.  I stay conservative in fat grafting as you can always add more.

George Bitar, MD · Answer

Removing grafted fat from the face would be more difficult. There's no non-invasive way to remove the fat. However, your surgeon may put more fat than needed at first, knowing that not all the grafted fat will survive. So be patient and allow for some time to past. You may like the long-term result, but not the immediate result.

Mats Hagstrom, MD (license on probation) · Answer

I think patients are wise to stay with fillers for any facial work. fillers are precise predictable and forgiving. Grafting fat is the opposite. It’s unpredictable and unforgiving.

It’s especially difficult when working in areas of thin layers of host tissue like around the eyes.

If you don’t like the result of fat transfer you’re pretty much stuck with the results.

If the fat dies and becomes lumpy fat necrosis or if you don’t like the result it’s very difficult to reverse it.

If you need a second round of fat transfer then you’ll most likely need to pay for it.

When it comes to fat transfer it’s always better to stay conservative and slowly build up volume over multiple procedures until you reached the desired result.

Fascial fat transfer has a very long steep learning curve and the number of people Who got a result that’s different than what they had anticipated is high.

For facial volume work fillers is the gold standard in my opinion.

If you’re up for fat transfer then go slowly and make absolutely sure you’re working it was one of the most talented and experienced providers.

Best,

Mats Hagstrom, MD

Robert T. Buchanan, MD (retired) · Answer

Both fillers and fat grafting work wonderfully for the mid-face. I used to do fat grafting regularly but now do more filler with the advent of Juvederm Voluma, which I have had last over 5 years in this area. If you choose the right injector, you should not have to worry about reversing whatever is done. An expert injector will discuss at length what you desire and generally achieve that or, if anything, fall short requiring further filling. An expert can also obtain the same results with either. Therefore, concentrate on locating an expert instead of deciding what to do beforehand.

Richard P. Rand, MD, FACS (retired) · Answer

It is not true that "most" doctors prefer fat over fillers for the very reasons you mention plus the fact that fat might not take, might take irregularly, and if too much takes, it cannot be removed.

If I don’t like the result of the fat transfer, can it be corrected?

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