I Am 7 Weeks After my Full Face Fatgrafting and the Fat is Almost All Gone is This Normal?

It's common to feel as though the grafted fat is disappearing as the post-treatment facial swelling goes down. In my experience, it takes many months for the final fact grafting result to become evident. Studies show that the fat grafts continue to 'blossom" up to 18 months or so after surgery.

It is not uncommon for patient to feel that the injected fat is all gone after the initial swelling goes down.  I would suggest being patient and then evaluating the outcome, preferably comparing pre-op and post-op photos at 3-6 month.

There is no substitute for reviewing photos.  Unless your surgeon really did not put much volume in, there is no reason to believe that the fat is gone.  Generally 60-70% of the grafted fat survives.  However, what is true is that the swelling associated with the fat grafting disappears around this time frame creating the impression that the fat volume has disappeared.  It is for this reason that I am not a big fat transfer fan.  It is a set up to want more grafted fat.  By carefully reviewing the before and after photos and knowing where the fat was actually placed, it should be possible for your surgeon to demonstrate the volume from the grafted fat.

Unfortunately, fat grafting can be unpredictable as to its "take" or viability.  At this point, I don't think that you have had much take and the procedure will need to be repeated or you will need to consider another alternative like injectable fillers.

It's a little unusual for the fat to be completely gone in 7 weeks. Probably the swelling, which can be significant, is gone and it looks less volumized by comparison. However, fat grafting is very technique oriented. When done by someone experienced, the survival can be up to 70-80%. Fat must be harvested very tediously, prepared carefully and by specifically nd then inbjected by the smallest of amounts (like micro-droplets). Fat grafts must be small enough to aquire a blood supply fo rit to survive, and the smaller grafts have a much better chance.  Then the post operative swelling can be extreme for several weeks.

I have seen patients that have had fat grafts and virtually none survived and others who had faces much too full. One thing to keep in mind is that if the grafts are taken from the abdomen and the patient gains weight, the face can get very fat. Removing excess fat can be challenging.

E. Ronald Finger, MD

Savannah Plastic Surgeon