The Skinny on Fat Fillers
Reviewed by Timothy R. Miller, MD
It's a great concept: Take fat from somewhere on your body where you have too much (such as your muffin top, love handles or thunder thighs) and inject it into areas of your face where it is in short supply.
Fat fillers — which are injected during a procedure known as autologous fat transplantation or microlipoinjection — have long been used to add volume to the face and lips (not to mention other parts of the body like the breasts and buttocks). Fat injections may also help soften the appearance of acne scars.
Another treatment that involves the reinjection of your own cells is Laviv. This procedure involves the harvesting of your skin cells, which are then used to create Laviv injections to treat nasolabial folds.
Where Do You Sign Up? Not So Fast.
There are some downsides to using fat as a soft tissue filler. For starters, it involves a separate procedure to harvest the fat. This can be done during liposuction to another area of your body or as a standalone procedure solely for re-injection. In the latter, your doctor will use a needle or cannula attached to a small syringe or suctioning device to remove the fat. The fat is then sterilized, processed and re-injected into the target site.
Some of today's newer liposuction techniques, like water-assisted liposuction, gently flush fat out instead of destroying it, so there may be an opportunity to harvest fat for transfer. Some say the same is true with laser liposuction and Vaser-assisted liposuction.
The procedure length varies. If fat is removed and then re-injected as a standalone procedure, it may take about an hour or two. Anesthesia use varies based on the nature and extent of the procedure. If you opt for fat injections to your face, this will be discussed with your surgeon beforehand. In general, topical anesthetic will numb your skin before the injection.
Fat Injections: Pros and Cons
Your body naturally absorbs fat, so the surgeon must over-inject initially. Fat transplantation is also more costly than other soft tissue fillers because it is a more complicated and time-consuming procedure. The cost of the fat injection procedure can range between $2,000 and $4,000 and is rarely covered by insurance if it is done for cosmetic reasons.
Another downside: The results can be less predictable, though this is changing. Sometimes the fat can add volume to the treated area for just three to six months. But give it time. There is emerging evidence that fat injections, like hair transplants, enter a "hibernation phase" shortly after injection and awaken nine to twelve months afterward. You may see more results during this time. Additionally, modern fat transfer techniques can better preserve fat cells, and this can increase the longevity of your results. In some cases results are permanent.
Fat Fillers: Your Recovery
Recovery after fat injections is a bit more involved than that of other fillers such as Restylane or Juvederm. There may be significant bruising in the area where the fat was harvested and swelling where it was re-injected. You may also need a dressing applied to the harvest or donor site. You will also be told to avoid the sun while you are healing. Make-up with a sun protection factor of 30 or higher can help camouflage the redness and bruising during your recovery.
Fat Injection Risks
Risks of fat injections include bruising, swelling, redness and, potentially, fatty bumps beneath the skin. The results are less predictable, so there is a risk of dissatisfaction with your results as well.
Your surgeon will go over any pre- and post-surgery instructions carefully. You will likely be told to avoid certain medications that increase your risk of bleeding. These include common over-the-counter medications such as ibuprofen and aspirin, as well as some popular herbal and dietary supplements. Follow these instructions carefully as they will minimize your risk of complications.
Fat Injections: The Bottom Line
In skilled hands, fat injections may be an option for adding volume to your face or lips. In unskilled hand, the risks are many and must be weighed against the perceived benefits, especially in light of available long-lasting soft tissue fillers such as Sculptra or Radiesse. These fillers provide more consistent results. Talk to a qualified board-certified facial or plastic surgeon with extensive experience administering fat injections to see if you are a candidate. If the cost is prohibitive, ask your surgeon about payment or financing plans.
To view a comparison chart explaining the pros and cons of all available injectables, please click here.
About the Reviewer of this Article
Timothy R. Miller, MD, is double board-certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology-Head and Neck Surgery. His practice, Facial Aesthetic Concepts, is devoted exclusively to aesthetic surgery of the face and neck. Dr. Miller has offices throughout Orange County, Calif., and has operating privileges at many area hospitals, including the Mission Regional Medical Center in Mission Viejo, Calif., Saddleback Memorial Hospital San Clemente Campus in San Clemente, Calif., and the Pacific Coast Ambulatory Surgicenter in San Clemente, Calif.
Dr. Miller received his medical degree from the University of California, Davis School of Medicine, and completed a five-year surgical residency in Otolaryngology-Head and Neck Surgery at the University of Utah School of Medicine, followed by a facial plastic and reconstructive surgery fellowship accredited by the American Academy of Facial Plastic and Reconstructive Surgery. Dr. Miller is a Fellow of the American Academy of Facial Plastic and Reconstructive Surgery and the California Society of Facial Plastic Surgery.
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