Facial Rejuvenation (Fat Injections, Fat Grafting)

What is facial rejuvenation with fat transfer?

There are several terms used to describe the transfer of fat from one part of the body to another. Some examples include fat grafting, fat transfer, and fat injection. All these terms describe the technique of using fat as a natural filler to improve the appearance of the face.

Fat transfer aims to rejuvenate the face by enhancing the volume, altering the contours and reducing the appearance of wrinkles. It helps to restore the fullness of the facial tissues that is lost with aging. It has also been shown to improve the quality of the skin and the texture of the skin. Facial rejuvenation with fat transfer is used commonly in areas such as the cheeks, lips, eyelids, temples and for wrinkles around the mouth (marionette lines, nasolabial lines).

Fat transfer rejuvenates the face by changing the volume and contour but only minimally lifts or tightens tissues. Patients with significant laxity or sagging of facial and neck skin may benefit more from a face lift and/or neck lift. You will discuss the options for facial rejuvenation that are best suited to you and your goals during your consultation with your plastic surgeon.

Who is a good candidate for facial rejuvenation with fat transfer?

Facial rejuvenation with fat transfer is an excellent option for patients who would like to enhance the volume of specific areas in the face or restore volume that has been lost with aging. The fat injected into these areas increases the volume and improves contour to result in a more youthful appearance. Fat transfer is also useful to replenish lost volume causing wrinkles and hollowing. Fat transferred to deep smile lines, corners of the mouth, hollowed eyes and sagging cheeks can restore the volume and improve the effects of aging. Your plastic surgeon will meet with you in consultation and review your concerns and desired changes as well as your medical history to determine whether a face and/or neck lift surgery is the right procedure for you. Physical conditions such as high blood pressure, diabetes, smoking, kidney disease, heart problems, and other serious conditions will be assessed.

What is done during fat transfer for facial rejuvenation surgery?

Facial rejuvenation with fat transfer surgery is performed as an outpatient procedure and you will go home the same day of surgery. The surgery is performed under local or general anesthesia.

The fat is taken from your body and transferred to another area in your body, specifically the face for facial rejuvenation. The fat is taken from any areas on your body where you have extra fat. The most common areas for taking the fat are the abdomen, thighs and love handles. The fat is used as a natural filler. It is donated from your body and transferred back into your body so there is no risk of disease transmission or rejection.

There is a certain amount of fat transferred that melts away (known as resorption) because the fat tissue is depending on a blood supply provided in location where it is injected. Given this expected loss, an extra amount of volume of fat is injected at the time of surgery to overcorrect. This is to compensate for the resorption that will occur. The majority of the resorption is expected to occur in the first 6 to 8 weeks following surgery. After this, all volume that remains is expected to be permanent. To harvest (take) the fat, a small incision is made near the area that has excess fat to donate and liposuction is performed. To transfer (inject) the fat, a small incision is made in the face near the area that requires volume, contour and rejuvenation. The incisions are strategically placed in natural creases to minimize their appearance and they should be unnoticeable once healed.

Where is the surgery performed?

All surgeries are performed at Women’s College Hospital as day surgery by the plastic surgery senior resident under the supervision of a faculty plastic surgeon.

What to expect in the recovery? How long will I be off work? When can I resume exercise?

After your surgery, you will be able to go home on the same day accompanied by a family member or friend once all the effects of the general anesthesia have worn off. During the day, you should rest at home and not do not physical activity that will raise your heart rate or blood pressure for one week following surgery. You can do light leisure activities like reading or using the computer. At night, you should sleep with your head elevated on pillows or sleep in a reclining chair. Keeping your head elevated helps to reduce the swelling of your face. You can expect mild pain and may feel bruised in the areas that the fat was taken from. You will be prescribed pain medication. You should expect some bruising and swelling in the first 1 to 2 weeks. This bruising and swelling will gradually improve each week. You can expect to gradually increase your activities 1 to 2 weeks after surgery. You should not do any strenuous activities (raise your heart rate or blood pressure) until 4 to 6 weeks have passed since your surgery.

What results can I expect from the surgery?

Fat transfer can help rejuvenate your face by decreasing visible signs of aging in the face which may include deep lines below the eyelids and from around the nose to the corner of the mouth as well as improving the shape of the cheeks. Although there is some resorption of fat, the results of a fat transfer are permanent. However, a fat transfer does not stop the aging process.

What are the risks and possible complications of the surgery?

As with any surgery, there are some common complications that may occur. These include bleeding (hematoma formation), infection, poor wound healing, unfavorable scarring, pain (that may persist after the incisions have healed), facial asymmetry, facial nerve injury, skin loss, numbness/skin sensation changes, irregularities in the area where the fat was harvested, and the need for revision surgery.

When will I see the final results of the surgery?

Healing after fat transfer for facial rejuvenation surgery is a gradual process. There are typically only minimal incision but there will be some bruising and swelling that settles generally in 2 weeks following surgery. Some mild swelling may persist for several months, and it may take up to a year for your results to fully appear.