Fat Transfer to Face

Who is suitable for fat transfer ?

Fat transfer is suitable for patients who have lost volume in the face from the effects of ageing. Examples include hollowing under the eyes (tear trough ), the midcheek , malar ( cheekbone area) and temporal hollows. The procedure tends not to work so well for areas around the mouth such as the lips and nasolabial and marionette lines. The mouth is continually moving which does not allow the injected fat to lie in a stable position during healing and this effect results in a higher failure rate.

The fat transfer surgery

The procedure can be performed under local anaesthetic or general anaesthetic. Often if fat transfer is being combined with other procedures such as eyelid surgery or a facelift a general anaesthetic is preferable. The process involves performing liposuction to harvest fat from another site of the body . The common areas for fat harvest are the abdomen or inner and outer thighs. This fat is then centrifuged ( spun at high speed) which separates out the various components of the fat and the healthy fat cells can be extracted . These fat cells are then transferred into small syringes ready for injection. It is particularly important to use the very finest injection needles to allow the fat to be injected smoothly with no clumps of fat. The availability of injection needles of less than 1mm in diameter have greatly improved the technique and cannulas are now available to inject using microfat and nanofat techniques. The fat is injected very carefully in multiple tunnels within the face to allow the best integration into the tissues. There are no scars since the technique is simply a methodical injection process but needs to be carried out carefully and symmetrically on both sides of the face.

The recovery after fat transfer

There may be some discomfort in the areas from where the fat is harvested using liposuction but this is easily controlled with mild painkillers. There is usually no pain in the face from the fat injection itself. Bruising and swelling is common in the face which will subside over a two week period. In cases where a lot of fat has been injected even after the initial 2 weeks the face may appear a little puffy and mildly swollen for another week or two. It is important to abstain from vigorous exercise for approximately 6 weeks after the procedure. There may be fat absorption after fat transfer and so it will take 3 to 6 months as a minimum to fully appreciate the results. Once this time period has elapsed the results of the fat transfer is usually permanent.

The risks of fat transfer

The main risk of fat transfer is the failure of the fat from integrating into the facial tissues which is a process known as ‘graft take’. The failure rate is approximately 25 to 30% and many patients will require a secondary or top up procedure. The need for this is assessed after a 6 month period. In reality the majority of patients experience good improvement even when there has been a partial absorption of the injected fat and therefore the absolute need for a secondary procedure is small and can vary according to expectations.

Other risks of fat transfer include minor irregularities and asymmetry but these risks can be minimised using fine injection cannulas.

Infection and bleeding risks are very rare when fat transfer is performed as a sole procedure.

It is important to keep your weight stable after fat transfer since if there is a disproportionate weight gain the fat injected in the face can result in a chubby facial