Facial fat grafting: restoring what the face has lost
Ageing is deflation as much as descent. Fat grafting addresses the half that lifting cannot.
In short
- The ageing face loses deep fat as well as position; lifting alone can leave it tight but empty.
- Fat is harvested from the abdomen or thigh, processed, and placed in small quantities in many layers.
- A predictable proportion of grafted fat does not survive, which is planned for rather than avoided.
- Results are long-lasting once established, unlike filler, which requires repetition.
Why volume matters as much as lift
For a long time facial rejuvenation was understood purely as a problem of sagging. That model is incomplete. The face also deflates: deep fat compartments in the temple, mid-cheek and around the eye socket shrink, and the bone itself remodels and loses projection.
A face that has been lifted but not refilled can look pulled, because tension has been applied to a structure that has less underneath it than it used to. This is a large part of why some facelift results look operated.
Lifting restores position. Grafting restores substance. Most faces past a certain age need some of both.
How the procedure works
Fat is taken by gentle liposuction, usually from the abdomen or inner thigh, using a technique designed to keep the fat cells intact. It is then processed to separate the usable fat from fluid and oil.
Placement is the part that determines the outcome. Fat is deposited in very small amounts through fine cannulas, in multiple passes and multiple planes, so that each parcel of fat sits close to a blood supply. Large boluses in one place tend not to survive and can form lumps.
What survives, and what does not
Not all transferred fat takes. A meaningful percentage is reabsorbed in the first months, which is normal and expected. What remains after roughly six months has established its own blood supply and behaves like the tissue around it.
Because of this, surgeons plan for the loss. The face may look slightly full early on, settling to the intended result. Occasionally a second, smaller session is planned to refine areas that took less well.
Fat grafting or filler?
Filler is quicker, involves no downtime, and is reversible if hyaluronic acid based. It is an excellent tool for targeted correction and for people not ready for surgery.
Fat is your own tissue, behaves more naturally in large volumes, and once established does not need repeating. It requires a procedure and a recovery. Over ten years the arithmetic frequently favours fat, both in appearance and in cost.
Common questions
Is grafted fat permanent?+
The fat that survives the first six months is generally considered permanent, in that it lives as normal tissue. It will still age and can change with significant weight fluctuation.
Where is the fat taken from?+
Most often the abdomen or inner thigh. Only a small quantity is needed for the face, so this is not a body contouring procedure and should not be expected to change your shape.
How long is the recovery?+
Swelling is the main feature and is more pronounced than people expect for the first week. Most return to normal activity in seven to ten days, with refinement continuing for a few months.
Can it be combined with a facelift?+
Frequently, and with good reason. Repositioning and refilling at the same operation addresses both mechanisms of ageing and tends to produce a more natural result than either alone.
Have a question about your own face?
The most useful answers are personal ones. A consultation is an honest, unhurried assessment of your face and your goals, with no pressure to proceed.
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