One of the best ways to refresh an aging face is to restore the volume that has been lost. From fillers to fat transfer, plastic surgeons have many modern, effective methods available to deliver volume restoration.

Hyaluronic acid based fillers, such as Juvederm and Restylane, offer safe, reliable results with very little downtime. One drawback to off-the-shelf fillers is that the results are only temporary, and only truly work in the right situation.

Another option is the method of fat transfer. In this procedure, unwanted fat from one area of the body is utilized in the face for permanent volume. Many people believe it is the better long-term option for facial volume restoration as it is both permanent and a patient’s own tissue.

That being said, and with all of the positive buzz around fat transfer in general, the potential negatives can easily get lost in the mix. Board certified plastic surgeon Dr. Peter B. Fodor of Los Angeles details fat transfer to the face and how patients need to understands its drawbacks.

FAT GRAFTING TO THE BODY IS ALL THE RAGE
Fat grafting is revolutionizing the field of plastic surgery. Surgeons are removing fat with liposuction from areas where patients don’t want it, and are putting it in areas where they do want it. Body sculpting, buttock augmentation, and breast reconstruction are all benefiting immeasurably from the use of fat transfer.

Plastic Surgery Procedures Benefiting from Fat Transfer:

Buttock Augmentation
Body Contouring
Breast Reconstruction
Some surgeons, however, are finding that similar fat grafting techniques have major drawbacks when applied to volume restoration in the face. “Fat grafting into the face remains to be a very controversial subject,” shares Dr. Fodor. “It’s great in many ways. You don’t have to pay for a filler. It’s your own fat. Most people have enough that they don’t mind getting rid of it. But, there are a lot of negatives.”

Fat transfer to the face drawbacks.

#1 ASYMMETRY IN THE FACE DUE TO WEIGHT GAIN AFTER FAT TRANSFER
One disadvantage of using fat in the face has to do with the fact that fat cells fluctuate in size with weight. “Not uncommonly, patients have been found to gain weight after surgery,” explains Fodor. “They gain weight drastically in the augmented areas of fat, and they can be gaining that asymmetrically.”

While the results may look great initially, if weight fluctuates, the fat cells may change and the results change. This can lead to an asymmetrical result in the long term, a condition that is much easier to spot on a person’s face than on their body.

#2 ASYMMETRY IN THE FACE DUE TO UNEVEN RESORPTION AFTER FAT TRANSFER
When fat is transferred to a new position, it needs blood vessels to support it for it to survive and remain permanently. Fat that does not develop a blood supply is resorbed by the body. Facial asymmetry can also result from uneven resorption of the fat. “Not all fat lives. It depends on your technique, it depends on a number of things,” shares Fodor. “Fat can resorb from the face asymmetrically. Even from the lips.”

With hyaluronic acid fillers, on the other hand, surgeons can add or subtract from the results to achieve and maintain symmetry. An enzyme can be used to dissolve fillers if the result is more than what the patient desires, and fillers can be added to maintain correction over time as they are evenly absorbed.

#3 LONGER RECOVERY, MORE SWELLING & BRUISING
Swelling and bruising associated with fat grafting to the face may last for several weeks or more. This lengthy recovery time is not an issue when fat transfer is combined with a facelift, as that recovery is equally lengthy.

If a patient is looking for standalone volume restoration, they could avoid the extended downtime by opting for fillers instead. Fillers can do the job with very little risk and minimal downtime. Often, any bruising that does occur with fillers can be easily covered up with makeup the next day.


Peter B Fodor MD FACS
2080 Century Park E Suite 1511, Los Angeles, CA 90067
(310) 203-9818
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Peter Fodor MD
711 E Valley Rd #202c, Basalt, CO 81621
(970) 925-4900
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