shutterstock 1189798375-min

Before I reached a certain age (let’s just say, it rhymes with “sporty”), I’d only ever cared about what I considered to be an excess of body fat. I had, admittedly, never given much thought to the fat in my face — until it started to disappear. It hardly seemed fair: Did I really have to choose between a slim physique and a smooth face?

To see if I could bring back a bit of my baby face, I met with board certified UCLA plastic surgeon [Jason Roostaeian, MD](https://aedit.com/provider/jason-roostaeian-md-449). He explained to me that [facial aging](https://aedit.com/aedition/how-your-phone-might-be-aging-you) isn’t just caused by gravity, but also by the redistribution and loss of fat throughout the face. The result: wrinkling and irregularities. 

[Fillers](https://aedit.com/procedure/temporary-lip-fillers), he explained, can restore some of that lost facial volume and refresh the youthful contour temporarily. After discussing all of the risks, I decided to give it a try — peppering Dr. Jason with questions as he thoughtfully examined my face, injecting hyaluronic acid filler into my tear troughs and cheeks.

I tried not to wince as I wondered aloud: How often am I going to have to do this? “It varies from patient to patient,” Dr. Jason told me. “But plan on dermal fillers lasting about six months to a year.” 

While I’d never been stellar at mental math, it seemed obvious that, as a sporty-something-year-old, this was going to get pretty pricey by my golden years. “Once you get older, you’re better off getting a facelift with fat grafting,” explained Dr. Jason, “which will take care of the skin laxity and the volume loss at the same time.”

He had me at “[fat grafting](https://aedit.com/aedition/why-everyone-is-talking-about-fat-grafting).”

## __The Technique Used In Facial Fat Grafting__  

Sure, I’d heard about the [Brazillian Butt Lift](https://aedit.com/procedure/brazilian-butt-lift-fat-grafting) (during which plastic surgeons transfer [liposuctioned](https://aedit.com/procedure/power-assisted-liposuction) fat from the belly and flanks to bulk up the booty), but I had no idea that similar fat injection techniques were being used to permanently plump up cheeks, lips, under eyes — basically, anywhere [facial fillers](https://aedit.com/aedition/everything-you-need-to-know-about-dermal-fillers) were gaining fame. 

I needed to know: Why isn’t everyone doing this? “First off, it’s a surgical procedure that includes all of the associated risks and recovery time,” Dr. Jason explained. “Secondly, because fat is a living tissue, it’s less predictable — though, at the end of the day, using your body’s own fat as filler is always going to be the gold standard.”

When pressed for more details, Dr. Jason told me that although some doctors perform facial fat transfer procedures under local anesthesia, he prefers to use general to ensure patient safety and comfort. “We have to be very careful with our technique,” Dr. Jason told me. “Imagine we’re taking tiny seeds of purified fat and dispersing them throughout the area to give them the best chance to grow and survive, while providing a smooth, even result over time.” He said that plastic surgeons generally overfill areas of the face during a fat grafting procedure because it is not unusual to lose about 30 (or even as much as 50) percent of the transferred fat cells over time.

When I asked about possible complications associated with facial fat grafting, Dr. Jason pointed out that because a patient’s fat is their own tissue (known as “autologous fat”), there’s no risk of adverse reaction — though swelling and bruising are typical and may be quite pronounced. “Because we’re distributing the fat throughout a given area through a very small incision, we end up affecting a lot of tiny blood vessels, which is bound to cause bruising,” he shared.

## __The Facial Fat Grafting Procedure__   

Full disclosure: I don’t think I was totally listening at this point. Instead, I was already fantasizing about the fate of my face and whether it was possible to tack on this fat transfer treatment to an unrelated procedure I had coming up. Since I was going under anesthesia anyway, why not wake up looking younger? Dr. Jason told me that the facial fat grafting would add about 45 minutes to my existing surgery and that the recovery typically takes about two weeks. I decided to give it a go.

Right before my fat grafting surgery, I came face to face with Dr. Jason and his purple surgical marker. He sat in front of me, considering the peaks and valleys of my face before tracing a pattern along my contours. We then discussed possible donor sites during an informal body fat analysis (which I can only liken to swimsuit shopping with a stranger) to determine exactly where Dr. Jason would be harvesting the filler for my face. 

He planned to make a total of four small incisions: one in each thigh to collect the fat and then one in each cheek about halfway between my mouth and nose. It’s through the latter that he’d inject the fat after purifying it in the operating room.

## __Recovery After Facial Fat Grafting__

The next thing I knew I was lying in recovery with a surgical glove filled with ice water splayed across my face. I was too groggy to even wonder about my results. After about an hour, the nurse cleared me to leave, sending me and my husband home with instructions to apply cold packs consisting of gauze soaked in ice water for the first 48 hours and to sleep as upright as possible to prevent swelling.

Standing before my bathroom mirror, I looked like I’d passed out after a fraternity hazing: bloated, a little bruised, and covered in Sharpie babble. But my skin was so smooth, plump, wrinkle-free, and refreshed. Though Dr. Jason had told me that the initial swelling from the procedure would obscure the final result, I was already pleased.

For the first 48 hours, I was totally unproductive. The cold packs made reading or even watching TV too challenging, but, after a couple of days, I was able to be up and about around the house — albeit with soreness in my cheeks and at the donor site. I’d also developed moon-shaped magenta bruises across each tear trough that seemed to be growing larger and darker daily. 

I realized that not being equipped with the proper concealer was going to be problematic. I threw on a baseball cap, pulled the brim down extra low, and ran to CVS to grab a tube of color corrector. I dabbed the makeup over the bruises, took a step back, and saw a woman with purplish-green shiners staring back at me. But, man, she looked so young.

## __The Results After Facial Fat Grafting__

Over the subsequent weeks, I became pretty adept at camouflaging my ever-changing bruises as they morphed and shrank unevenly from red to purple to blue, green, and yellow before finally fading away. If anyone noticed my technicolor transformations, they didn’t let on (with the exception of my mother-in-law, who deadpanned, “You look like you’ve got two black eyes.”). 

When I asked Dr. Jason whether or not it was typical for patients to have lingering bruising, he said it generally “clears up completely within 10 days or so. But every patient is different.” For me, caking on the concealer for a few weeks seemed a small price to pay in exchange for a positive, permanent result.

Dr. Jason also told me that it would take about three months for the swelling to subside completely and the surviving fat to become established. With the passing weeks, every sign that appeared from my “old” face made me wonder: Would I end up looking happily refreshed or disappointingly unchanged? 

I felt strangely conflicted. On one hand, I was incredibly satisfied with my initial appearance, but I was equally reluctant to invest too much in the outcome. Notes from my journal about one month post-op capture the conundrum: “Woke up this a.m. and the left smile wrinkle was back. Ugh. Yesterday went shopping without concealer — felt amazing.”

By the time I saw Dr. Jason for my three month follow up, the soreness in my cheeks and thighs (initially akin to a pulled muscle) and small red scars from the incision sites had completely resolved. Much of the fullness in my cheeks and the evenness under my eyes remained. As Dr. Jason evaluated the outcome, I held the hand mirror and saw no apparent signs of plastic surgery other than a slightly younger self was staring back at me, smiling.

AEDITION expert perspective-min

Patient Perspective Collection | The AEDITION

Patient Perspective

After growing weary of the price and upkeep associated with dermal fillers, one writer decided it was time to try something a bit more permanent.

What It's Really Like To Get Facial Fat Grafting 

shutterstock 650888758-min

If you’ve thought to yourself, I wish I could take some of the fat [here](https://aedit.com/procedure/thigh-lift) (gesturing to your thighs) and put it in up [here](https://aedit.com/procedure/breast-augmentation-with-fat-transfer) (gesturing to your breasts), well, you can. And while you’re at it, you can even put some of that flab under your eyes and into your [cheeks](https://aedit.com/procedure/cheek-augmentation-with-fat-transfer)—or whatever area of the body you could use some extra volume. The appeal of getting rid of fat where you don’t want it and adding it to where you do is why fat transfer procedures (also referred to as fat grafting or fat injection) are on the rise. In fact, a survey of plastic surgeons conducted by the [American Society of Plastic Surgeons](https://www.surgery.org/sites/default/files/ASAPS-Stats2017.pdf) showed that fat transfer to the face was up by 22 percent in 2017.

## How Does A Fat Transfer Work?

A fat transfer works with the surgeon performing [liposuction](https://aedit.com/procedure/power-assisted-liposuction) on a "donor site"—usually the stomach or thighs—to extract fat through a small incision and using a cannula. “You don’t need to be particularly heavy to have this done,” says [Michael Frederick, MD](https://aedit.com/provider/michael-frederick-md-643), a board certified plastic surgeon at the Hass Plastic Surgery & MediSpa in Palm Beach Gardens, Florida. “There are very few people I can’t get any fat out of.” Then, the doctor rinses the fat to remove broken fat cells, oils, and other things that might be mucking it up. (There are a few different rinsing techniques; [Jason Bloom, MD](https://aedit.com/provider/jason-bloom-md-2248), a facial plastic surgeon at the Main Line Center for Laser Surgery in Ardmore, PA, uses Puregraft, which resembles an IV bag with filters in it.) The doctor injects the rinsed fat into areas of the body that you’d like to be a little fuller, like your [butt](https://aedit.com/procedure/brazilian-butt-lift-fat-grafting), breasts, and face. This may sound intense, but as cosmetic procedures go, it's pretty straightforward and done under local anesthesia. You might experience some soreness and swelling in the area where fat was extracted, but it will only last for a few days.

## What Are The Perks Of Fat Grafting? 

The first major perk of fat grafting is that you’re getting a two-for-one deal here: reducing body fat in one area and enhancing another, all in one appointment. You can even have your harvested fat injected into more than one part of the body at a time. Patients also like that it’s a natural way to create volume; instead of having a foreign substance inserted into your body (like silicone [breast implants](https://aedit.com/procedure/breast-augmentation-with-implants) or synthetic [facial filler](https://aedit.com/procedure/under-eye-filler), you’re using your own fat. This reduces the chances of rejection or allergic reaction and can produce more natural-looking (and feeling) results. Plus, the results are permanent, as opposed to synthetic fillers that only last a few months. “There is retention of 70 to 75 percent after five years,” says Dr. Bloom.

Fat grafting procedures can also help rejuvenate the skin, although it’s a slightly different type of fat transfer than the method used simply to increase volume. “Nanofat grafting involves harvesting fat and then passing it through a series of screens or meshes to grate down the fat cells to stem cells, which can revitalize the skin,” says Bloom. Research that appeared in the journal [Plastic and Reconstructive Surgery](https://www.ncbi.nlm.nih.gov/pubmed/23783059) showed remarkable improvements in skin quality and facial rejuvenation six months post-operation. However, this method doesn’t really increase volume, so Dr. Bloom sometimes uses a combination of both types to give a patient fullness while also revitalizing the skin.  

## What To Keep In Mind About Fat Grafting

Experts say fat transfer procedures are an effective way to add volume to the face and body, but as with all surgical procedures, there are a few side effects to keep in mind. For one, “it’s somewhat unpredictable,” says Dr. Frederick. While [fat grafting](https://aedit.com/aedition/what-its-really-like-to-get-facial-fat-grafting ) is great at creating volume, but it doesn’t work as well for contouring and fine-tuning. This is why Dr. Bloom uses the fat grafting technique in some areas of the face, like under the eyes, in the cheeks, and along the jawline, but not others, like in the lips, which require precise shaping. The same issue applies to fat transfers to the breasts. “While it can increase the size of your breasts, it doesn’t create shape,” says Frederick, who sometimes uses a combination of implants and fat grafting to create natural looking breast augmentation. Another potential downside to transferring fat to the breasts is that it can sometimes cause benign cysts referred to as fat necrosis. If the fat is not dispersed properly, “it won’t get the blood supply that it needs, which causes the fat cells to die. And you could wind up with areas of hardened fat,” says Dr. Frederick.

Lastly, fat can get homesick. “Fat acts the same way, no matter where you put it,” says Dr. Frederick. For example, if you tend to gain weight in your stomach, and you have fat removed from your lower abdomen and injected into your butt or your boobs, you’ll now be more prone to weight gain in those areas. But, hey, if big boobs or a big butt is your goal, consider this an added perk.




AEDITION trendsetters-min

Now Trending Collection | The AEDITION

Now Trending

The biggest trend in cosmetic surgery is fat grafting, which takes fat from one place to plump another. Here's why.

procedures

by concern

by area

most researched

The AEDITION

collections

most popular

The AEDITION

Fat Grafting