Any site in the face can be injected with fat graft. However, if a site is suitable in a particular individual is generally determined by overlying skin quality.

It is not possible to place a fat graft under thin, wrinkled poor quality skin. This risks visibility and lumpiness.

Common sites for fat grafting in the face are cheeks, lips, chin and the perioral area. The upper and lower eyelids as well as the forehead can be grafted in some cases, however, does depend as previously stated on skin thickness.

In most people, neck skin is too thin for fat grafting and risks visibility and lumpiness. Some chest and neck lines can respond to nano fat grafting but only in selected cases.

Facial fat grafting is typically used in conjunction with other facial rejuvenation procedures.

Lasers, bioremodelling agents and PDO threads can all improve overlying skin quality enhancing fat grafting results.

Liposuction incisions to harvest facial fat tend to be small around 5mm) and are placed in hidden locations such as below the underwear line or in creases.

Injection points for the face are done in the hairline, lip and creases and are only slightly bigger than a large gauge needle so tend to heal with an imperceptible scar.

It is uncommon for scars to be visible for very long after facial fat grafting. If  you are prone to more significant scarring such as hypertrophic or keloid scars due to genetics or other factors,  advice will be given on extra scar management.

Most facial fat grafting is done under general anaesthetic in an accredited private hospital facility.

Whilst smaller facial fat grafts could be done under local anaesthetic and sedation, this is usually more painful and can take longer as the patient is not totally comfortable.

Facial fat grafting is done as day surgery and patients must be accompanied home by a responsible adult regardless of the type of anaesthesia used.

Waterproof dressings are placed over the liposuction harvest sites and these should stay intact until you come for your review in around one week.

The small injection points on the face have brown steristrips placed over them. These should also be kept intact for as long as possible until your review.

You are given spare dressings to go home with and reinforce the ones you have if needed.

Icing the face and sleeping slightly upright can minimise facial swelling.

Commencing oral Arnica two days before surgery and continuing this for one week after surgery can be beneficial in reducing visible bruising.

Pain from facial fat grafting does not tend to be significant in most and simple analgesics are usually adequate if no other procedure has been done.

The liposuction or harvest site tends to be the most painful, however pain does depend on the volume harvested. There may be bruising at the liposuction or injection sites.

Long acting local anaesthetic is injected at the time of surgery to help with post-operative pain relief. This tends to wear off after around half a day and oral pain relief will be needed.

In the uncommon event that pain after the surgery is not under control, Dr Simone and her anaesthetist are available at any time after your surgery to advise about pain relief.

Patient are generally socially presentable within 7-14 days.

The small access points on the face are healed at 7 days and no longer have tapes on them. The liposuction access points also have their sutures removed at this time.

Following this, time to social presentability depends on bruising and swelling which differs from person to person. Taking Arnica two days before and continuing it for one week after can help reduce brusing.

Some sites such as the lips and eyelids can develop more visible swelling and bruising compared to the cheeks, however, every person’s tendency to bruise is different.

Lip fat grafting can take longer to settle This depends on the type of work, some patients can be back within a matter of days to a desk job.

One of the overriding advantages of facial fat transfer are the tiny incisions and rapid healing time which means there are no major restrictions to exercise after the surgery.

Exercise is mainly limited due to pain in the liposcution sites, which is highly variable and usually dependent on the overall liposuction volume.

Swimming and very vigorous exercise causing a lot of sweating can usually be resumed at one week once stitches are removed.

After a facial fat graft, most people would feel well enough to go back to a normal desk job and light duties within a day or two (if you are not required to be socially presentable).

This can vary if a large amount of liposuction has been done which causes more pain and downtime.

Grafted fat behaves like living fat in the site from which it has been harvested. Therefore it is subject to changes with weight loss and weight gain.

Final fat graft take tends to be visible at 6 weeks with smaller amounts of loss occurring over the first three to six months.

Sudden changes in an exercise regimen, drugs or weight loss could lead to accelerated fat graft loss years after the graft.

Fat grafting is commonly used in conjunction with facelifting in small amounts.

Generally repositioning of the cheek tissues with a deep plane facelift means that not much volume needs to be added to the cheek area. However, areas not addressed by the facelift such as the perioral marionette lines, temple hollowing, glabellar lines, tear trough, A-frame (upper eyelid) or lips can be improved with fat grafting at the time of a facelift.

There is plenty of fat available during a larger volume liposuction for facial fat grafting.

The technique used for facial fat harvest is less traumatic than VASER liposuction in order to preserve the integrity of the fat.

However, the fat graft for the face can be harvested prior to VASER liposuction in an area and then the area can have contouring completed with VASER (skin tightening)  liposuction.

Click here for more information on VASER liposuction.

This link gives the common general risks of all plastic surgeries involving general anaesthesia.

Haematoma or seroma This is a collection of blood (haematoma) or fluid (seroma) . This is a rare occurence, as volumes of injection and harvest are small in facial fat grafting. These will mostly resolve on their own without further intervention.

Variable fat graft take This is the most common risk with fat grafting; not knowing how much will take in a given person. The average take rate is 60-70% and in thin people or those with scarring it is on the lower end of the range or less.

Fat graft changes with weight loss or weight gain Facial fat grafting is not a good procedure in those that have major weight fluctuations. The tendency in most is to get less take than desired. However, there have been cases where several kilograms of weight gain can lead to out of control growth of the fat graft and a very puffy appearance.

Other causes of changes in fat graft volume Starting a new drug can cause fat graft growth or loss if it impacts fat metabolism. Whilst the graft once stabilised should remain permanently, many factors can impact fat metabolism and lead to long term changes in the fat graft.

Facial asymmetry – No face is perfectly symmetrical. Even if equivalent volumes are injected or an attempt is made to correct more significant facial asymmetry, at times fat graft take may vary between sides of the face. This can be due to differences in scarring or blood supply for example or other reasons. Whilst every attempt is made to improve more significant facial asymmetries, it is important to understand perfect correction cannot be achieved.

Palpable lumps Rarely fat graft can form lumps, especially in areas where there is thin skin cover. Whilst many resolve with time, if there is excessive lumpiness the only way to remove it is surgical removal as facial fat does not respond well liposuction.

Altered sensation Fat injection to the face rarely impacts facial sensation or motor function. More commonly there is numbness in the harvest site for some months, however, it usually returns to normal. Some patients can experience hypersensitivity following liposuction but in the majority this settles but may take some months.

Undesirabble cosmetic result Whilst every effort is made to discuss your surgical goals and ensure your expectations are realistic, there is a variability in results which needs to be accepted when undergoing facial fat grafting procedures.