Facial Fat Grafting

Fat grafting, also known as fat transfer to the face or fat injections, is a cosmetic procedure designed to minimize facial aging by repurposing your own fat cells. As the natural aging process begins to diminish fullness and volume in the youthful contours of the face, the cheeks can appear sunken and hollow. Creases and wrinkles can also become more pronounced, and jowling may develop along the jawline. Fat grafting can be an effective facial rejuvenation treatment to restore areas of lost volume in the face, as well as to smooth the appearance of fine lines and facial folds. The procedure uses your own body fat, harvested from a fat-rich region of the body through liposuction, to make strategic additions of volume to facial creases and sunken areas. The harvested fat is purified before redistribution into the face, and the use of your own fatty tissue generally cancels any risk of an allergic reaction. Beverly Hills-trained Boston plastic surgeon Geoffrey Leber, MD, FACS has proficient expertise in this natural facial filler technique stemming from his training under Dr. Richard Ellenbrogen, known as the “Father of Fat Grafting.”

• Facial Fat Grafting Benefits
• Facial Fat Grafting Candidates
• Facial Fat Grafting Procedure
• Facelift vs. Facial Fat Grafting
• Facial Fat Grafting Recovery
• Facial Fat Grafting Results
• Facial Fat Grafting Scars
• Facial Fat Grafting Cost
• Non-Surgical Facial Fat Grafting
• Facial Fat Grafting Alternatives
• Complementary Procedures

What Can Facial Fat Transfer Do for Me?

Facial fat grafting is a versatile procedure that can achieve a number of cosmetic goals, depending on your unique aesthetic concerns. A supplementary benefit of this anti-aging treatment is that the body area used to harvest the fat cells—typically the medial knees, thighs, hips, or abdomen—can be contoured through liposuction in conjunction to the fat grafting procedure. Dr. Geoffrey Leber personalizes the surgery according to the goals of each patient’s treatment plan. Fat grafting can generally be utilized to improve:

• Loss of cheek volume
• Loss of lip volume
• Loss of fullness along the jawline
• Diminished volume in the temples
• Sunken areas under and around the eyes
• Deep creases that extend from the nose to either side of the mouth (“marionette lines”)
• Facial folds, wrinkles, and shallow scarring in the face

Facial fat grafting can lead to very natural-looking and long-lasting results. Patients often combine fat grafting treatment with other enhancement procedures, such as eyelid surgery or a facelift, for more comprehensive facial rejuvenation.

How is Fat Transfer to the Face Performed?

The fat grafting procedure has two main components. First, a very thin tube called a cannula is used to gently extract fat from a body area with an adequate amount of excess fatty tissue. This is accomplished through manual liposuction techniques utilizing a 10 cc syringe, which generally allow an optimal amount of surgical control and fat graft survival when transferring the fat cells. Next, the fat is centrifuged, allowing the removal of excess oil and blood. This purifies the stem cells and fat before injection into targeted regions of the face. The fat cells and accompanying stem cells are then utilized to fill in facial depressions, smooth wrinkles, and restore youthful volume to the treated areas. Adjunctive benefits of this treatment include skin rejuvenation properties derived from the stem cells of the fat graft(s). This often results in smoother skin with fewer fine lines, decreasing pore size and pigment irregularities.

Facelift vs. Facial Fat Grafting

A facelift and facial fat grafting can both be excellent options to rejuvenate the face, but the similarities between the two procedures generally end there. Facial fat grafting is a volume-enhancing procedure while facelift surgery is considered a method of skin tightening. Although the results of each facial plastic surgery can complement each other, a facelift and facial fat grafting are not interchangeable.

Fat transfer to the face is performed to enhance hollow areas, a sunken look, or deep creases caused by a loss of facial volume. Common treatment areas include the temples, cheeks, lips, and jawline depending on each person’s goals. Unlike this volume-enhancing procedure, a facelift is primarily designed to remove jowls (hanging skin along the neck and jawline) and sagging skin, which can give patients a sleeker and smoother facial contour. Facelift surgery can enhance facial angles to help you look more youthful, but the procedure is generally not recommended for age-related volume loss. Consulting with a board-certified plastic surgeon like Dr. Leber can help you confirm the best procedure to address your unique concerns.

What is Recovery Like for Facial Fat Transfer?

Depending on the details of your treatment plan, most individuals can make a full return to normal activity in three to seven days. Mild swelling at the injection site is common, but should dissipate within a few weeks of treatment. Fat graft survival is dependent on the technique used and where it is injected in the face. There is a survival rate of up to 70-80 percent in the cheeks and lower eyelid regions, with less fat graft survival in more mobile areas, such as the lips.

While the cosmetic results of facial fat grafting can be immediately apparent, the final outcome generally improves as swelling continues to dissipate. Dr. Leber utilizes advanced surgical techniques when extracting and redistributing the fat into facial areas, which can allow a natural-looking and long-term aesthetic result.

How Long Does Fat Transfer Last?

A major benefit of fat transfer to the face is that results can far outlast the effects of non-autologous injectable products, and most patients experience permanent rejuvenation. The technique of harvesting and injecting fat affects the ultimate fat graft take. Small parcels of fat injected into different tissue planes have the best chance of becoming viable from the surrounding well-vascularized tissue.

If a large volume of fat is injected into an area, the central fat will fail to incorporate into the tissue and will generally be resorbed by your body. Fat graft survival is analogous to how a skin graft survives. However, even if the best technique is utilized, some of the fat will be resorbed. Fat grafts generally have a better percentage of survival when injected into tissue beds that are more stationary and less mobile.  For example, a higher percentage of fat graft take can be expected around the eyes and cheeks, with less fat graft survival in the more mobile areas around the lower face and mouth. The process of non-viable fat graft resorption takes around six weeks.

Dr. Leber tells his patients that the fat surviving after six weeks has become a part of their face, deriving new blood supply from the healthy surrounding tissue and therefore becoming a permanent improvement in volume. If additional volume is desired, a second fat grafting procedure can be performed, adding to the prior improvement in volume and providing the desired long-term improvement. That said, the normal aging process will eventually lead to further loss in facial volume.  Additional fat grafting may also be desired after 5 to10 years as facial volume is lost with the normal aging process. This is largely dependent on your individual genetics and lifestyle.

Will I Have Scars From Facial Fat Grafting?

Fortunately, unlike other surgical procedures, fat transfer typically does not leave detectable scars. The fat is reintroduced to the face with a small blunt-tip microcannula, making it easy for Dr. Leber to avoid noticeable scarring. Access incisions are made with a small needle that heals without a visible scar. If you would like to assess the visibility of post-surgical scarring for yourself, please feel free to explore our before-and-after photos for facial fat transfer.

How Much Does Facial Fat Transfer Cost?

Fat transfer to the face can generally cost anywhere between $2,500 and $7,000, although this range is not necessarily specific to our practice. The price of fat grafting usually depends on the extent of your concerns and the amount of fat transfer necessary to achieve your goals. After these individual factors are assessed by Dr. Leber, our patient care coordinator will be able to provide you with a personalized quote of your procedure. Some patients opt to pay for facial fat transfer through our third-party plastic surgery financing companies, CareCredit® and Prosper® Healthcare Lending. Each financial lender offers qualified candidates their choice of several payment plans, allowing patients to select the arrangement best-suited to their unique budget. As a result, the facial fat transfer procedure can be pursued right away while payments are made in low monthly installments. One of our team members can explain the process to you in further detail, so please don’t hesitate to contact our practice if you have any questions. 

Is Non-Surgical Fat Grafting Possible?

No, unfortunately the procedure can only be performed through a combination of liposuction surgery and fat injection to the face. While liposuction is among the least invasive cosmetic procedures available, treatment still requires surgery. That said, you can still add volume to depleted areas of the face using injectables and dermal fillers. Performed in-office with the assistance of a local numbing agent, fillers can still enhance fullness in the lips, cheeks, temples, and other sunken regions of the face. In addition, BOTOX® Cosmetic and other neurotoxins can temporarily relax the facial muscles and smooth wrinkles around the upper face. These non-surgical treatments can still provide noticeable facial rejuvenation, but the outcome will be temporary and touch-up appointments will be necessary to maintain your results.

Are There Any Alternatives to Facial Fat Transfer?

If you would like to replenish your facial volume but would rather avoid surgery, Dr. Leber offers minimally invasive alternatives, such as Restylane® and JUVÉDERM®, to fill nasolabial creases, marionette lines, and enhance sunken contours. These hyaluronic acid fillers can add fullness to the cheeks, lips, under-eye hollows, temples, and jowls, among other areas depending on where you desire improvement. While the effects are not permanent, these dermal fillers can help erase signs of aging without surgery or downtime. Our aesthetic nurse injector can suggest an optimal treatment plan based on your needs and concerns.

Complementary Procedures to Facial Fat Grafting

Fat transfer to the face can help restore fullness and volume, but the procedure isn’t designed to address other concerns like jowling, sagging tissue, or disproportion between the facial features. If you’re considering more than one cosmetic procedure to gain more extensive improvment, you may be interested in one of the following treatment options:

• Facelift: By correcting jowls and other signs of aging in the lower face, a facelift can further refine your facial angles and complement the rejuvenation provided by facial fat grafting.
• Neck liposuction: If you’re bothered by excess fat in the submental area (often known as a “double chin”) on top of a flat, sunken look, liposuction in the neck can help slim the face and create a sharper jawline and facial profile.
• Chin implant: For those who have a weak, unpronounced, or recessed chin, a custom chin implant can balance your facial features and strengthen the jawline.

Dr. Leber can develop a combined treatment plan, similar to a Mommy Makeover or post-weight loss body contouring surgery, for patients who want more harmonious and comprehensive facial rejuvenation. He would be happy to listen to your goals and recommend the best treatment(s) to achieve your desired look.

For more information about facial fat grafting or other anti-aging treatments, or to schedule a consultation with Dr. Leber, please contact our practice today.