Article medically reviewed by Dr. Gavin Chan (MBBS, cosmetic physician, liposuctionist)
Templestowe Lower and Berwick Clinics
Dr. Gavin Chan has a background in intensive care, anaesthesia, and emergency medicine. Since 2004, Dr. Chan has provided cosmetic procedures, including anti-wrinkle injections, dermal fillers, liposuction, fat transfer, skin needling, and laser treatments. He is a doctor trainer for various dermal fillers and anti-wrinkle injections.
What is facial fat transfer or fat grafting?
One of the changes that occurs with ageing is the loss of facial volume due to facial fat loss. This can start to occur even in your thirties. Ironically, ageing and facial fat loss is often accompanied by an increasing difficulty in reducing unwanted body fat. Naturally, the remedy for this may be to transfer some of this fat back towards the face with facial fat transfer.
A key advantage of the fat transfer procedure is that it is 100% natural as it uses your own fat. It requires no incisions in the face and leaves no facial scars. Another advantage of facial fat transfer is that stem cells are also transferred with fat cells. Stem cells are the regenerative cells of the body that are found in abundance within fat. They can help to regenerate the face, when transferred there, and lead to improvements in skin quality and appearance.
By strategic replacement of facial fat and facial volume, it is possible to regain youthfulness and a more healthy appearance to the face. Facial fat transfer can also be used to improve balance in the face.
What areas can be treated?
The key goals of facial fat transfer are to replace volume that is lost with time. This can help to smooth transitions between one area of the face to the next area of the face. For example, fat can be placed in the tear troughs, the hollow between the eye bags and the cheek, to smooth the transition between these areas. Also replacing volume in certain areas, such as the cheek, can help to improve the youthful contours of the face. Finally, fat can be used to balance the proportions of the face, for example, fat can be placed into the chin if it is recessed in comparison to the nose or cheeks.
Some commonly treated areas include;
- around the eyes, to smooth the transition between the lower eyelids and the cheeks
- the cheeks – to lift the face, shape the face into a more youthful face by enhancing the upper cheeks, and replace lost volume
- lips – to enhance size and shape
- nasolabial folds – to soften the fold between the nose and the mouth
- jawline / chin – to straighten the appearance of the jawline without a facelift
- mouth corners (marionette lines) – to reduce the appearance of the diagonal folds going down from the corners of the mouth
- areas outside the face can be treated also, such as the back of hands and buttocks (Brazilian Butt Lift).
What is involved with fat transfer?
Video: Dr. Gavin Chan discusses and demonstrates a facial fat transfer process on ABC Catalyst
Firstly, a consultation is required to see if you are a suitable candidate for facial fat transfer. The face is assessed to determine where the the placement of fat may help contour and smooth the face, and the volume of fat required is assessed also. Suitable areas on the body for fat harvesting will be assessed, and the quality and volume of fat for harvesting will also be assessed.
The procedure itself can be done either awake or with some level of sedation. This will depend on the patient’s preference, and the degree of treatment being performed.
The procedure begins with fat harvesting from the pre-determined site or sites on the body. Commonly used areas are the abdomen, inner thighs, outer thighs, and hips/waist. The fat is harvested by liposuction. Facial fat transfer only requires a small amount of fat and therefore only a minor liposuction needs to be performed. This minor liposuction can be done usually with very fine instruments and very small incisions in the skin that are often so minor that they do not even require suturing.
Generally, this minor liposuction makes no discernible reduction in the treated area, nor does it cause any significant post-operative discomfort. If a size reduction of the area is required, a more significant liposuction can be performed (at the request of the patient). The end result is that an appropriate amount of fat is harvested into syringes that are then prepared for re-injection into the face. Usually enough fat is taken for a few fat transfer procedures – the fat not used in the initial procedure is frozen for subsequent transfers in the patient.
At Victorian Cosmetic Institute, we also use platelet rich plasma (PRP), which is a part of blood, to help improve the chances of fat survival in the new location. A small volume of blood is taken prior to the procedure, and put through a special centrifuge that separates whole blood into red blood cells and platelet rich plasma. The platelet rich plasma is then mixed with fat and injected into the face. The platelet rich plasma acts as a ‘fertiliser’ for the transferred fat. It releases growth factors that help the fat regenerate in its new location as well as activate dormant stem cells residing within the fat. It also gives the fat a smoother consistency which makes it easier to inject.
Local anaesthetic is injected into the face to numb the treated areas. The local anaesthetic also contains a small amount of adrenaline which helps to constrict blood vessels and reduce bruising. Fat is injected using fine microcannulas, which are like blunt ended needles.
The key with injecting fat is to spread the fat evenly and smoothly. This helps to improve the chances of the fat taking up a new blood supply and regenerating.
After fat transfer, the face can be swollen and bruised, and of recovery times are about 1 week on average.
The final result for fat transfer may not sometimes be seen for a few months. After the initial swelling has subsided there may be a period where the transferred fat is in the process of regeneration and attaining its own new blood supply. Once this has been achieved, the full effect of the fat transfer may be seen.
The effects of fat transfer can remain for many years.
How many treatments are required?
The number of treatments required will vary from individual to individual. As fat transfer is generally not a reversible process, it is important to avoid over-treatment. As a rule, under-treatment is preferred. Therefore, we generally prefer to perform a series of fat transfer procedure to achieve an ideal result.
The space between each fat transfer procedure should be at least two months if not more. Usually subsequent fat transfer procedures do not require liposuction, as enough fat has been harvested during the initial procedure to be frozen, then thawed just prior to utilisation in future fat transfer procedures.
What are the differences between dermal fillers and fat transfer?
Dermal fillers can also be used to revolumise the face. There are a number of key differences between the two.
|Fat transfer||Dermal fillers|
|Minor liposuction procedure required to harvest own fat for transfer.||Dermal fillers are pre-packaged, immediately ready for injection|
|Can transfer as much fat as required to multiple areas of the face without adding significant cost.||Cost is priced per mL of dermal filler used, and when large amounts are used it can be costly.|
|Requires more than one session for ideal results. Fat can be frozen for future use.||Mostly requires only one session for ideal results.|
|Longevity can be for many years. Small chance of fat not ‘taking’ leading to no result.||Longevity of most temporary fillers is about 6 to 18 months.|
|Fat transfer has the added benefit of also transferring stem cells||No stem cells in dermal fillers|
|Softer more natural appearance||Has greater lifting capacity in certain areas, eg cheeks/chin|
|More downtime required, as different technique required to injection than dermal fillers||Usually less bruising / swelling / downtime than fat grafting|
|A surgical procedure that may require some intravenous sedation||Non-surgical. Done in clinic in about 30 minutes|
Why should I choose Victorian Cosmetic Institute as my provider of facial fat transfer?
At Victorian Cosmetic Institute, we specialise in facial fat transfer. Our techniques have been developed to optimise outcomes for you and to reduce any risks or side effects. The procedure is performed in our accredited day surgery.
Any surgical or invasive procedure carries risks. You should discuss these with your surgeon.
Making that first phone call can be a confronting task – many of our patients have preferred filling out our online enquiry form. We can then contact you with an understanding of the results you are hopeful of achieving and ensure the treatment is appropriate.