What is facial fat grafting

Facial fat transfer is a minimally invasive cosmetic procedure that utilizes a person's own fat, taken from areas such as the hips, thighs, abdomen, or neck, to restore or enhance facial volume. This technique, also referred to as facial fat grafting, fat injections, or lipofilling, can help replenish fullness in the cheeks and temples, plump thin lips, refine the results of eyelid surgery, and smooth deep lines around the mouth, such as nasolabial folds and marionette lines. It is also effective in improving the appearance of pitted acne scars.

Performed as an outpatient treatment, facial fat transfer involves extracting excess fat through gentle liposuction, sometimes processing it with a centrifuge or filter, and then carefully injecting the purified fat into targeted facial areas to create a more youthful, lifted, and smoother appearance. The most widely used technique, microfat transfer, involves injecting fat in tiny droplets, often called microdroplets, leads to more of the fat surviving the transfer process.

Further refining the fat through processing creates nanofat, which enhances thin, delicate skin, particularly under the eyes and on the upper lip. Unlike microfat, nanofat does not contain intact fat cells, as they rupture during processing, meaning it does not provide volume enhancement. Instead, it serves to improve skin tone, texture, and overall quality.

Since fat is an abundant source of stem cells, using autologous (self-derived) fat for facial rejuvenation offers additional anti-aging benefits. The stem cells and growth factors present in the fat stimulate collagen production beyond the treated area, contributing to an overall more youthful appearance.

Nanofat, which contains fat-derived stem cells but no whole fat cells, is solely used for tissue regeneration. Some practitioners enhance nanofat or microfat injections by incorporating platelet-rich plasma (PRP) or platelet-rich fibrin (PRF) to amplify regenerative effects. In the case of microfat, this combination has been shown to increase the likelihood of graft survival, according to a recent study.

How much does facial fat transfer cost

Facial fat transfer surgery costs in Australia are generally considered expensive in comparison to other countries around the world. To have this procedure in Australia, you can expect to pay within the range of $4,000AUD to $8,000AUD and often even more if a highly skilled surgeon who specializes in this area has been selected.

The average cost for facial fat transfer surgery in the USA is around $5,000USD. However, the price can again be much more if a specialist surgeon is chosen to perform the procedure. Facial fat transfer surgery costs in Mexico are generally considered to be quite affordable in comparison. You can expect to pay between $1,500USD to $6,500USD for this procedure. In Turkey, the cost is even lower and can start from $1,750USD. The price for a facial fat transfer in Turkey can be up to 60% less than in the US, UK, and Europe. 

Several factors will determine the price of your surgery, these factors include the skill, reputation and expertise of the selected surgeon, the hospital and anesthetist costs, with prices being higher in more affluent areas. This procedure can also be performed in various ways with varying amounts of fat being harvested and transferred. The complexity of the procedure, how much fat is needed as well as if the procedure is being combined with any others will also affect the overall cost.

How is facial fat transfer performed

A facial fat grafting procedure consists of three stages and can take up to two hours, depending on the amount of fat being transferred and other specific factors.

The process begins with liposuction to extract excess fat from predetermined areas of the body, chosen in consultation with your surgeon. Local anesthesia with oral sedation is typically administered, though general anesthesia may be recommended in certain cases. A small incision is made in the donor site, allowing the surgeon to insert a thin, hollow tube called a cannula, which gently suctions out the fat. Careful handling during this step is crucial to ensure the fat cells remain intact and viable, as standard liposuction techniques can damage a significant portion of them.

Once harvested, the fat undergoes a purification process where it is spun in a centrifuge and filtered to eliminate any impurities. The purified fat is then transferred to smaller cannulas for injection.

To complete the procedure, the face is numbed with local anesthesia, and the surgeon uses a tiny cannula to inject the fat into the targeted areas. This process involves multiple passes to ensure that each tiny portion of fat is placed near living tissue with an adequate blood supply, which is essential for its survival. Many surgeons opt for a slight overcorrection since not all injected fat will ultimately integrate into the tissue. However, careful precision is necessary to avoid excessive filling, which can decrease the fat’s viability. Once placed, the transferred fat cells must establish a new blood supply to remain in the treated area successfully.

How to prepare for facial fat transfer

Preparing for facial fat transfer surgery begins with a consultation with a qualified plastic surgeon, or with several which is even better. Once a surgeon has been selected, you'll discuss your goals, medical history, and identify suitable fat donor sites for fat harvesting, such as the abdomen, thighs, or buttocks. Your surgeon will also help set realistic expectations, explaining both the potential benefits and limitations of the procedure. Before the procedure, you'll receive instructions that may include avoiding certain medications, quitting smoking to aid healing as well information regarding your after care. It should also be mentioned that maintaining a stable weight is important for optimal results as weight gain and loss will have an affect on your results.

On the day of the procedure, you'll need to arrange for transportation home, since the effects of anesthesia will make it unsafe to drive yourself. Recovery involves rest to minimize swelling, taking prescribed pain medication as needed, and following a balanced diet while staying hydrated to support healing. After the initial recovery phase, gentle movement and light exercise can help promote circulation and overall recovery.

What are the risks and possible side effects of a facial fat transfer

Facial fat grafting is generally considered a low-risk cosmetic procedure, particularly compared to larger-volume fat transfers to areas like the buttocks, the procedure uses smaller amounts of fat and finer cannulas, making complications less common.

However, as with any surgery, there is always the possibility of infection or an unsatisfactory outcome. Some patients experience lower fat survival rates, which can lead to asymmetry. Other potential risks include hematoma, where blood pools under the skin, fat embolism from fat blocking a blood vessel, scarring, and in rare cases, fat necrosis or cyst formation if the transferred fat fails to integrate properly.

Additional risks include fat overgrowth if excessive fat is injected or if significant weight gain occurs later, leading to a distorted or uneven appearance. Minor side effects may include prolonged swelling, redness, and acne flare-ups.

More serious complications are rare but possible, particularly neurological side effects caused by accidental injection into a blood vessel. This seems to be more common when fat has been injected into the frown lines, temples or forehead. Even so, the likelihood of such complications is extremely low—approximately one in 5 million cases.

Medical opinions vary on fat transfer for the under-eye area. Some doctors discourage it altogether, while others maintain that, when performed correctly, it yields natural, long-lasting results without complications. Some practitioners even consider fat transfer essential when performing lower eyelid blepharoplasty. One 2018 study on combining fat grafting with lower blepharoplasty for tear trough correction reported no serious complications over a 10-year span.

The lips are another debated treatment area. Some surgeons carefully inject fat into the lips, while others prefer hyaluronic acid fillers for more predictable results. Because lips are constantly moving, grafted fat in this area has a lower survival rate, though patients tend to appreciate the natural effect while it lasts.

Ultimately, the success of facial fat grafting heavily depends on provider expertise. Choosing a surgeon with extensive experience in the procedure, as well as reviewing their portfolio of long-term results, is essential for achieving the best possible outcome.

How long do results from a facial fat transfer last

The results you achieve nine to ten months after your procedure are generally considered lasting. However, changes in weight—whether gain or loss—can impact the transferred fat cells, potentially altering facial proportions. Additionally, as part of the natural aging process, volume in the treated area will gradually diminish over time.

One of the biggest challenges with fat grafting is the unpredictability of fat retention. Some of the transferred fat inevitably reabsorbs, but exactly how much remains permanently varies from patient to patient. In rare cases where the final outcome results in more volume than desired, reversing the effect is particularly difficult. Unlike hyaluronic acid-based fillers, which can be dissolved with an enzyme, removing excess fat is a more complex process.

Steroid injections may help in some cases and options like micro liposuction or direct excision may be considered to remove unwanted fat deposits, particularly if lumps or irregularities develop. However, most patients naturally lose facial fat over time, meaning any excess volume will gradually diminish.

If a provider recommends using Kybella to reduce excess fat, especially under the eyes, seeking a second opinion is advisable. Kybella is FDA-approved exclusively for treating submental fat under the chin, and its use in other facial areas carries risks, including excessive fat dissolution, which can lead to contour irregularities and hollowed features.

To ensure confidence in your results, some doctors suggest previewing the effects with a temporary filler such as Restylane or Juvéderm before committing to fat transfer. Others advise against this approach, arguing that fat grafting should ideally be performed on untreated skin, as existing fillers may interfere with fat cell survival. An alternative method for evaluating volume changes involves saline injections, which provide a short-lived but immediate visualization of potential enhancement.

How long is recovery from a facial fat transfer

Recovery from facial fat grafting generally takes about a week, with most people able to return to regular activities within three to five days. However, it may take a few additional days before you feel comfortable going out in social settings.

During the first week, it’s common to experience swelling, bruising, and tenderness at the injection sites. The areas where fat was harvested through liposuction may also feel sore and swollen for a couple of days. While discomfort is usually manageable without prescription medication, your provider may suggest over-the-counter pain relievers.

Swelling typically diminishes within two weeks, and keeping your head elevated—especially while sleeping—can help reduce puffiness. Most surgeons advise against using ice, as it may interfere with fat cell survival. Bruising in the treated areas should also fade within two weeks and can be concealed with makeup if needed.

To protect your skin and promote healing, use a mild facial cleanser and avoid scrubbing the treated areas until inflammation has fully resolved.

Is facial fat transfer or fillers better for you

Fat injections serve a similar purpose to temporary dermal fillers, offering both facial contouring and wrinkle reduction. While fillers typically consist of a synthetic hyaluronic acid-based gel, fat transfer involves injecting fat harvested from the patient's own body. Fillers provide predictable results, require no downtime, and can last anywhere from six months to over a year, depending on the amount used.

Though fat transfer tends to deliver longer-lasting results, its initial cost may be higher, and the outcomes can be less predictable. A skilled provider specializing in facial rejuvenation can help determine whether fat transfer or dermal fillers are the better option for an individual's needs. Another possible pitfall with facial fat transfer is that there are some areas of the face where injecting fat isn't recommended and may be more susceptible to potential negative side effects as discussed above.

Several highly regarded filler choices are available, each suited to different areas of the face. Renuva works by creating a supportive matrix that encourages natural fat cell growth over time. Juvéderm offers a variety of hyaluronic acid fillers designed to address volume loss across different facial regions. Restylane similarly provides temporary enhancement for lips, cheeks, under-eye hollows, scars, and hands. The RHA Collection is engineered to closely mimic the skin’s natural movement, making it well-suited for treating dynamic wrinkles and folds. Sculptra Aesthetic differs from traditional fillers by stimulating collagen production to restore facial volume in the temples, midface, and jawline, though it is not recommended for use in the lips or around the eyes.