Facial Fat Transfer: Minimally Invasive, But Risks Remain

Fat transfers date back to the late 1800s, but it wasn’t until the 1990s that the technique became more reliable.

Going by many names — fat grafting, fat injection, or lipofilling, among many others — fat transfer is simply the moving of fat from one location of your body to another. Facial fat transfers use fat to lift wrinkles and contour the face.

What is facial fat transfer?

Facial fat transfer removes fat from one area of your body to be injected into your face. It can be done during a facelift or by itself. Patients use the procedure to smooth wrinkles and contour the shape of their face — it replaces other dermal fillers. Facial fat transfer provides a more natural look to your face.

How is a fat transfer done?

There are three steps to fat transfers: collecting the fat, processing the fat, and then injecting the fat where it is wanted. Fat transfers require only a local anesthetic. However, general anesthesia is often used if combined with a facelift. No matter which type of procedure you choose, the steps for the fat transfer remain the same.

First, a surgeon makes an incision that is then made into the skin and down to the fat layer and collects the required amount of fat — the stomach, hips, and butt are often used. Then, being careful not to cause too much bleeding or damage to the fat cells (adipose cells), the surgeon suctions out the amount of needed fat.

The collected fat is then purified. Purification isolates only the best fat cells. Because the procedure removes more than just fat cells, the other components — blood cells, skin cells, or fluids — need to be separated. Those other components increase the risk of developing complications. A centrifuge separates the different components. The surgeon then injects the best fat cells into your body.

This process is often repeated in four to six months to fill in missed areas or where the fat cells died. Results from fat transfer often last many years if a constant weight is maintained.

What to expect after a fat transfer?

Whether you decide on a full facelift or simply a fat transfer injection, there’s a short recovery period. In the first few days after the procedure, you experience swelling and bruising at the donor site(s) and your face. You can also expect some soreness or pain. Your surgeon will supply pain medications as needed. These side effects from the procedure generally resolve in a couple of weeks.

You should notice a change to your face after the bruising and swelling clear up. The results may not be perfect after your first procedure. Facial fat transfer often needs to be repeated a couple of times to achieve the desired effect.

Fat transfer risks

As with all medical procedures, there are risks involved with fat transfer. Thus, you must understand the risks before undergoing the procedure.

Risks include:

• Discomfort.
• Bruising.
• Cellulitis — a bacterial skin infection.
• Deformity from poorly placed injections.
• Fat cell necrosis — the death of fat cells.
• Blood clots.
• Hematomas — bad bruising.
• Fat embolism — like a blood clot, a fat embolism can obstruct veins and arteries, leading to potentially more serious health concerns.

Always discuss any questions with your surgeon. You should feel confident in your understanding of the procedure.

Fat or fillers, is one better than the other?

Dermal fillers are gel-like substances injected under the skin to change the contour of an area of your body. These include hyaluronic acid (HA), calcium hydroxylapatite (CaHA), poly-L-lactic acid, polymethylmethacrylate (PMMA), and fat transfer. Each has its specific use guidelines — and its benefits and drawbacks. Fat tends not to be as firm as other fillers, so you may wish to use a mix of fat and other fillers. Overall, fat transfers tend to be safer. Using your body’s cells helps to avoid the risks of an allergic reaction. Additionally, your body has a ready supply of fat cells in several donor areas.

You need to discuss what you are looking to accomplish with a facial fat transfer with your surgeon. Make sure your surgeon is board certified and qualified in the procedure. Also, make sure your doctor uses only dermal fillers approved for your type of surgery.

If you have any questions, do not hesitate to speak with your surgeon. Make sure you are comfortable with your surgeon and that you understand each step of the procedure.