FAQs About Fat Transfers with Dr. Guyuron

fat injections

Fat transfers to the face are one of the most popular rejuvenation techniques. It involves removing small amounts of unwanted fat from another area of the body and injecting them into the face. It restores youthful fullness that is more permanent and natural looking. Dr. Guyuron answers questions from patients about the facial fat transfer procedure and a similar technique: fat grafting.


Q: What is the best way to treat hollow cheeks and eyes to fuller ones? Is fat grafting long-lasting? 

A: The combination of the flat cheeks and hollow eyelids, which is extremely common and sometimes seen in young individuals, is a perfect setup for fat injection. Not only will fat injection fulfill the goal of restoring the missing volume, but it also contains stem cells that provide a glow to the face that cannot be achieved in any other way. Always consult a board-certified plastic surgeon who has sufficient experience with fat injection to the face.


Q: I’ve always had very hollowed eyelids. Would fat injection help hollowed eyes/dark circles?

A: Hollowness around the eyes can be best improved with fat injection. However, one must be careful about augmenting the eyelids on someone who has deep-set eyes which can make the eyes look even deeper. Fat injection lightens the dark eyelids. If necessary, a laser could be used to lighten the lids further. Your droopy eyelids can be improved with the removal of the redundant skin and shortening of the stretched mules.


Q: Is fat transfer possible for a very thin face?

Fat injection can be done almost under any circumstances and is better suited for those who are thin and lose volume in the face. It is always possible to find fat to harvest even in thin patients.

Q: Does fat injection leave marks?

A: Needle marks are not an issue with the fat injection and lumpiness is rare in experienced hands and if it occurs it is correctable.


Q: How can I help my results last with a facial fat transfer? 

A: The most important thing patients can do to increase their fat survival after injection is to avoid smoking and minimize the movement in the fat injected site. On the other hand, there are many things that the surgeon can do to augment the chance of fat injection success. These range from the choice of the injection site, the choice of the graft donor site, to the technique of purifying the fat, to the technique of aspiration and technique of injection. The patient’s age at which fat is injected makes a difference as well. The younger the patient the more successful the fat injection results are.


Q: What is the difference between a direct fat graph vs. a fat transfer?

A: While these two techniques share some common features, they are different in several regards and need to be individualized. Fat graft requires a donor site and thus produces a visible scar unless it is harvested during another procedure whereby fat could be harvested without a new scar. This fat will only serve as a deep filler in the form of a segment. Fat injection, if it is used as the deep filler will be unlikely to cause irregularities, like a deep fat graft. However, there is no discernible donor site scar. Injected fat contains stem cells and can improve the color and elasticity of the skin and fat graft is not capable of producing this change.


Q: How many CCs of fat can be transferred to the cheek area at once?

A: There is not a defined limit as to how much fat can be injected into the face at one time. The goal is to inject enough during the initial injection to achieve a natural-looking attractive change and in experienced hands one injection often achieves the intended results. However, on rare occasions, it might be necessary to inject additional fat or remove some if the retained volume is beyond what is expected.


Q: What are the actual risks of fat grafting to treat under the eye hollows and cheeks? 

A: The risks associated with the fat injection to the lower lids include lumpiness, excess volume, inadequate volume requiring additional injection, asymmetry, and extremely rare potential for loss of vision if fat gets into the eye vessels and some other rare complications. The risk is reduced within the hands of an experienced plastic surgeon. Those of us who use fat injection on daily basis have been able to minimize fat injection complications and many of us have never had a patient with blindness. Using conservative volume, injecting deep, using a blunt needle, injecting agents that shrink the vessel, and having experienced all reduce the potential complications.


View the before and after results from our beautiful 33-year-old patient, Amanda, who had a fat transfer to her lower eye area.


Eye Fat Transfer - Before


Eye Fat Transfer - After