Fat Transfer

As the face ages, there becomes a generalized and increasing loss of volume (fullness) to the regions of the midface (cheeks), around the eyes, around the mouth, temples, prejowl sulcus, and nasolabial folds. Contrary to older surgical theory centered on removing “sagging” tissue, lifting and pulling “drooping” tissue, Dr. Sparano values techniques of volume restoration. While the older techniques did address some of the anatomic problems with the aging face, they did not address a significant underlying problem – volume loss. As we age, even beyond the troublesome effects of gravity, our face appears aged mostly because of the loss of facial volume we experience decade after decade. Fat transfer (also known as fat grafting) is a direct and natural way to counter these changes.

Fat transfer is the procedure of transferring fat from unwanted areas of the body (e.g., lower belly, inner thighs, hips) to areas of the face which have lost fat through the aging process. The procedure involves a small incision at the navel or inner thigh, through which fat is safely and easily harvested through a small blunt probe. The fat is then cleansed and concentrated prior to injection into the desired pre-planned facial subunits. There is often some associated swelling and bruising that is transient, with very little downtime.

Fat transfer is an effective way to add volume back to the face using one’s own natural tissue. It is extremely effective and safe, and the individual fat grafts should last significantly longer than any purchased filler agent. Dr. Sparano utilizes the most up-to-date equipment and techniques to maximize the longevity of his fat transfer results.


Who is a good candidate for fat transfer?
Healthy individuals with volume depletion of certain aesthetic subunits of the face are good candidates for this procedure.

Is fat transfer an effective way to treat skin wrinkles?
While an effective fat transfer can efface certain types of wrinkles indirectly, it is designed more to volumize contours of the face for improvements in form. The skin itself is more directly addressed with topical agents, chemical peels, laser resurfacing, or fine line facial fillers.

Is general anesthesia needed for fat transfer?
Dr. Sparano performs fat transfer in an outpatient setting using local anesthesia and oral sedation, as well as in an operating room setting by patient preference, or when combined with other surgical procedures. Facial fat transfer is often performed in conjunction with facelift and eyelid procedures.

Is the procedure painful?
After the initial injections of anesthesia, the procedure is associated with minimal discomfort. There can be some general soreness of the abdominal or thigh regions following the procedure, which can be controlled with a gentle pain relief regimen.

How soon can I return to work after a fat transfer?
Most patients feel they are too swollen in the face to return to work within 5 days. After the first 5 days, apparent recovery depends on how quickly any individual’s inflammatory response subsides and whether there is any associated bruising.

How long will the results of my fat transfer last?
This is actually a very interesting question which is often discussed within the community of facial plastic surgery. We have learned that usually, at least a fair percentage of the transferred fat may last forever. As to whether the surviving fat will yield the desired aesthetic outcome forever, is a different issue. There is no doubt the results can last different durations for different individuals. Most patients experience a beneficial result for beyond 2 years. These results can persist as long as an indefinite duration. Generally, we’ve learned that 40-70% of the transferred fat tends to persist for a great duration.

Should I choose fat or other facial fillers to address my facial needs?
This is another good question which certainly depends on an individual’s needs. Dr. Sparano believes each modality (i.e., fat transfer versus injectable facial fillers) has its pros and cons respectively. Fat is likely to last longer and should have greater cost-effectiveness. It usually has some associated downtime, however, unlike the other injectable facial fillers.

For a generalized volume loss to the face, fat transfer tends to be the best option for a patient. When an isolated are needs volume enhancement and a patient is not undergoing additional surgical procedures necessitating downtime, other injectable fillers become the preferred option. Dr. Sparano also believes there is definitely a necessary artistic sensibility when deciding when, where, and how much fat to inject versus other facial fillers. Dr. Sparano has these conversations with patients in detailed consultation.