Fat transfer techniques have come a long way in the past ten years. Better equipment and better understanding of how to transfer fat has increased the rate of fat retention.
The options for augmenting the face are weight gain (yes!), fillers such as Restylane, Juvederm, etc. and patients own fat.
The advantage of fillers is initial lower cost, faster treatment time and less down time. The disadvantage is all fillers will eventually dissolve, requiring repeat injections every 6-12 months.
The advantage of fat transfer is that the retained fat is permanent. In some cases, an additional fat grafting procedure may be required. In majority of cases, therefore, 1-2 treatments will result in permanent correction. In the long term, therefore, fat grafting is more cost effective.
I have also noted with fillers, when the patient animates his/her face, the filler stays stationary and the rest of the face moves around the filler. This is especially true when a patient is trying to rejuvenate the whole face with fillers (this is a very common finding with actresses). The fat moves and behaves more naturally, resulting in less motion “artifact”.
There are also certain areas which I only recommend fat grafting: correction of over-resection of upper eyelid skin and fat, and improvement of dark circles around the lower eyelid. The upper and lower eyelids are the thinnest skin in the body. In my experience, it is almost impossible to place filler under the skin without noticeable irregularities. The fat can be emulsified so that it is very smooth and a very tiny amount can be placed to correct the area. Although risk of irregularities is always present with any filling procedure, it is much safer with fat grafting.
The procedure is usually performed under local anesthesia, thus avoiding the cost and potential complications and recovery of general anesthesia.
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 18 years of experience. His offices are located in Santa Ana, California. To schedule a complimentary consultation, please call (714) 834-0101.