As time goes by, many of us lose the fullness in our faces. We begin to see cheek hollowing and temple hollowing, thinner lips and flatter cheeks. Laugh or smile lines appear around the lips. Reduced volume in certain facial areas is an inevitable part of the aging process, but with fat grafting to the face we can build back the volume, minimize wrinkles and revitalize the appearance.
Fat grafting is an excellent surgical procedure done under local or general anesthesia to restore facial volume lost through the years and also to bring a little more symmetry to the face. Patients go on to see noticeable results with natural looking, fuller cheeks, temples, lips and eyelids.
What is fat grafting?
Fat transfer to the face or face fat grafting is a popular technique many patients ask me about. Fat grafting is like doing dermal fillers to the face but using your own fat. Fat is removed from any fatty deposits in the body, prepared as a filler and injected into facial areas that have lost volume, such as cheeks, temples, lips, folds and wrinkles.
Fat grafting surgery is done on an outpatient basis, and has quick healing times and immediate results.
Do I need fat transfer to the face?
You are a good candidate for fat transfer or facial fat grafting if you want to rejuvenate your face with more volume and make it more balanced and symmetrical in appearance. You might consider a fat grafting to the face procedure when:
- You have loss of fat in the cheek area creating hollow cheeks.
- You have loss of fat on the forehead and see hollow temples.
- You lack natural contouring near the jawline and need to add volume.
- You would like to fill the upper or lower eye area.
- You want to have fuller lips and reduce the lines around the lips.
- You want to add fullness back to all areas of the face.
- You want a more permanent alternative to fillers treatments.
Using the patient’s own fat to tranfer into the face is one of the best fillers we have to inject.
How is the fat grafting procedure performed?
The areas of the face we address in facial fat grafting are the areas where we see the most volume loss. We lose volume in the cheeks, the upper and lower eyelids, temples, lips, jawline, chin. and experience hollowing of these areas.
The procedure can be done under general or local anesthesia. Under local anesthesia this is how it works:
- We give oral sedation to the patient combined with local anesthesia depending on the scale of the procedure.
- We remove fat from the patient’s own body, typically in the “trouble areas” such as the abdomen, thighs and hips.
- The fat is then prepared and purified and becomes the patient’s own natural filler.
- Next, we inject the fat with very fine cannulas into the facial areas needing replacement.
- We inject the fat through the face multiple times, carefully depositing the fat filler into the areas we chose to improve.
The fat grafting procedure can be performed just for the face, or some patients choose to have a full body liposuction first. We will retain the collected fat from the liposuction and prepare it for transfer to another part of the body. This is a great additional procedure, as we use part of the fat removed during the liposuction for the face.
Do I need to be sedated during fat grafting to the face?
A larger facial fat grafting procedure may be done under sedation or with a general anesthesia, while many small fat grafting procedures can be performed using a local anesthesia, where the patient is awake. Oral sedation can be used if under local anesthesia, but the patient remains awake, just more relaxed. We can decide what method is best for you when we discuss the procedure.
Does fat grafting hurt?
There is minimal discomfort as we numb all of the areas of the face and around the area where we extract the fat (abdomen, waistline, thighs…).
How long does fat grafting last in the face?
We estimate that 50% of the fat injected is permanent. During the healing process, there is some fat absorption, but the fat that remains is permanent. The aging process will still occur, but patients enjoy a beautiful result for years.
What facial fillers can be used other than my body fat?
We love using synthetic fillers such as hyaluronic acids (HAs) for improvement of facial hollowing and loss of volume. However, if the patient has available fat to collect, we know that fat is a great material to use. We utilize the body’s own natural reserve to improve facial aging.
Is there non-surgical face contouring instead of fat grafting?
Yes, we have several non-surgical face contouring techniques and facial harmonization procedures. These are a combination of individualized facial treatments with fillers and neurotoxins, suspension sutures and sometimes small surgical procedures. Dermal fillers, HAs, and collagen production stimulators, can also be used to reshape the face and create beautiful results.
Will others see my fat grafting incisions?
No, the fat grafting incisions should not be visible. Only a small incision is made at the fat removal site.
What is the fat grafting surgery recovery time?
Recovery time depends upon how much fat is transferred and how many areas are treated. The average downtime is about 2 weeks after the procedure. Some patients have more swelling or bruising than others, so it may take about 3 weeks for the most visible signs of surgery to be gone.
After fat grafting surgery how can I have healthy skin?
Fat grafting does not stop the aging process, but it is a “reset” in time. We offer a number of medical skin treatments and products to help maintain the results long term. A healthy lifestyle is also a part of the maintenance of any facial rejuvenation procedure.
How can I get started to learn more?
If you are interested in discussing fat grafting surgery, non-surgical facial fillers or any other facial rejuvenation procedure it will be my pleasure to see you in the office for an in-person consultation. We can talk about what you want to achieve, go over the specific areas you are looking to improve, and I will answer any questions you have.
Plastic surgery through a woman’s eye
Dr. Gabriele Miotto, Atlanta plastic surgeon known for her beautiful, natural results and high patient satisfaction.
Surgery and Recovery Information
After the fat grafting procedure
Facial fat grafting is an outpatient surgery done under general or local anesthesia. After the procedure, there will be visible fine skin sutures in the incisions, some bruising and swelling.
Facial fat grafting is not a painful procedure, but mild discomfort and feeling of tightness in the face and neck areas are expected for a few days to a few weeks after surgery. Bruising and swelling are usually the cause of the discomfort. However, it can be treated with preoperative and postoperative medication and supplementation, ice and anti-inflammatories. Swelling can be minimal or more intense depending on how many procedures need to be done in surgery to make the results the most beautiful and natural possible.
Return to normal daily activities between 1-2 weeks. Expect at least 8 weeks for committing to major social events as residual swelling can remain for some patients after surgery. We are all different, so it is hard to predict who will get more or less swelling and bruising.
General preoperative recommendations for fat grafting:
What to avoid before the procedure:
- DO NOT take any aspirin for 7-10 days before your scheduled procedure. Do not take NSAIDS (Aleve, Motrin, Ibuprofen) for 5 days before surgery. You may take Tylenol (Acetaminophen) if needed for aches or pains. Please contact the office at if you have any questions about any medications that you are taking or if you are prescribed aspirin by your cardiologist or Primary Care Provider (PCP).
- Discontinue Vitamin E 10 days before surgery.
- Avoid the following herbal supplements for 10 days before surgery: Echinacea, Ephedra / Phentermine (used for weight loss), Feverfew, Fish Oils, Garlic, Ginkgo Biloba, Goldenseal, Kava-Kava, Licorice, Saw Palmetto, St. John’s Wort and Valerian.
- Stop Smoking. The harmful effects of smoking can cause tissue death, infection, and open wounds. It also makes you age faster!
- Alcohol can promote swelling of the surgical area and it is best to avoid alcohol intake for at least one week before surgery.
What to take before surgery:
- Dr Miotto will recommend medications and supplements during your consultation to speed up recovery after surgery.
General postoperative recommendations after fat grafting:
- If the procedure is done under general anesthesia, you MUST have a responsible adult to transport you home and stay with you for a full twenty-four hours after your surgery.
- You will be unable to drive if you are taking narcotics.
- It is recommended to elevate the head with two to three pillows after all facial procedures.
- Your initial post-operative appointment will be scheduled by your Patient Care Coordinator; please make arrangements to have reliable transportation for these appointments as you will not be permitted to drive until twenty-four hours after general anesthesia and when you are no longer taking narcotic pain medications.
- Please refrain from physical activity that will increase your heart rate or blood pressure for 1 week after surgery. However, bed rest is NOT recommended, and you should be walking at normal pace after the procedure.
- You can shower twenty-four hours after surgery. You may clean the incisions as instructed by Dr Miotto or her nurses after the procedure.
- Do not submerge yourself into a tub/pool until all wounds have healed (usually in 2 weeks).
- Do not scrub the surgical sites, however you can allow soapy water to run over them.
- Avoid lotions on the surgical sites for 1 week, but you can moisturize any other areas as desired.
Returning to Work:
- Recovery time will vary; however, most patients return to work within 1-2 weeks after the procedure, within one week you will have a feel for your specific limitations and will be able to determine how comfortable you will be with resuming your daily activities and workload.
- Immediately following surgery, it is best to eat bland, easily-digested food and avoid excess sugar and salt. Healthy proteins (eggs, lean meat, beans, nuts), rice, fruits and cooked vegetables (broccoli, peppers, sweet potatoes) will provide your body with nutrients essential for healing.
- Eat a few bites of food before taking pain medications as these can cause nausea.
- A diet low in sodium will help minimize swelling and water retention.
- Drink plenty of water! Drinking low sugar sports drinks and protein shakes are recommended.
- Keep in mind that our goal in aesthetic surgery is improvement and not perfection. You will be followed closely after surgery to assure that you heal well and have the best possible results.
- It can take months for the very final results of your surgery be apparent. After 12 weeks, you can expect your results to be mostly permanent. Expect subtle changes in swelling and healing (including the appearance of scarring) to continue to improve for up to twelve months.
- It is important for you to keep open communication with your physician and return for your follow up visits. We will take pre and post pictures along the way and look at the final results together.
GABRIELE C. MIOTTO MD, MEd., is a Brazillian-American plastic surgeon specialized in aesthetic surgery and minimally invasive procedures, specially of the face, eyes, breast and liposuction.
Call 404-850-5851 for your consultation.