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The Comprehensive Guide to Cosmetic Facial Fat Grafting: Understanding the Risks and Benefits

Published on March 14, 2024

In the quest for youthful vibrancy and a rejuvenated appearance, cosmetic facial fat grafting has emerged as a popular and innovative procedure. This minimally invasive technique involves transferring fat from one part of the body to the face, offering an alternative to synthetic fillers for enhancing facial volume and contour. While the allure of a more youthful and refreshed look is undeniable, it’s crucial for potential candidates to weigh both the benefits and the risks associated with this cosmetic procedure. Let’s delve into the intricacies of cosmetic facial fat grafting, providing a balanced perspective to help you make an informed decision.

What is Cosmetic Facial Fat Grafting?

Cosmetic facial fat grafting, also known as autologous fat transfer or fat injection, is a procedure that uses an individual’s own fat with the promise to improve the volume, texture, and overall appearance of the facial skin. The process typically involves three key steps: liposuction to extract fat from a donor site (such as the abdomen or thighs), purification of the extracted fat, and the careful injection of the fat into specific areas of the face that require enhancement.

Claimed Benefits of Cosmetic Facial Fat Grafting

  • Natural Results: Since the procedure uses the patient’s own fat, the results tend to look and feel more natural compared to synthetic fillers. On should take this claim with a grain of salt. The fat has to establish a blood supply. Approximately ½ to 2/3 of the fat dies. It is replaced with scar tissue. At first there is swelling associated with the service, this effect is gone after 6 months often leaving the face looking depleted but occasionally with a loss of the normal facial contours due to deep tissue scaring.
  • Long-Lasting Effects: The outcomes of fat grafting can be longer-lasting, with many patients enjoying the benefits for several years. However as noted above, much of the transferred fat does not survive and is replaced by unhelpful scar tissue.
  • Dual Benefit: This procedure offers a dual benefit – reduction of unwanted fat from the donor site and enhancement of facial features. This is also a deceptive claim. Unless you are specifically getting a body liposuction, the amount of fat removed from the donor area is small and the resulting contour improvement is minimal at best.
  • Safety: Being a minimally invasive procedure, it carries fewer risks than major surgical interventions, with a relatively short recovery period. Also debatable. While rare, vision loss is a known potential complication of grafted fat. Don’t underestimate grafted fat. It is still a surgery, requires anesthesia, swelling and brusing can be profound and requires real time for recovery. This is not a “minimally” invasive procedure.
  • Versatility: Fat grafting can address multiple facial areas simultaneously, including the cheeks, lips, under-eye hollows, and temples. The down side it that it is very challenging to control how the body will respond to the grafted fat that does survive and takes in the body. There is no real finesse with this procedure.

Risks and Considerations

  • Variable Results: The survival rate of transferred fat can vary, leading to unpredictable outcomes and the potential need for additional procedures. A recent 16 month study of cheeks augmented with fat grafts found only a 30% survival of the implanted fat and a common need for additional grafted fat.
  • Complications: As with any procedure, there are risks of complications such as infection, bleeding, and asymmetry. But also rare but serious and debilitating complications such as loss of vision.
  • Overcorrection: There is a possibility of overcorrection, leading to an unnatural appearance if too much fat is injected. Late changes in the grafted fat are possible including loss of volume. Significantly, the graft fat behaved like the donor site fat. If you gain wait in the donor area, the harvest fat from that area will also gain in volume. This causes people to developed a chronic facial disfiguration. Think of those round faces in the paintings of Fernando Botero.
  • Recovery Time: While generally shorter than major surgeries, the recovery can involve swelling, bruising, and discomfort. At a minimum, you will be swollen even at 6 months after a fat grafting procedure. You should be skeptical of before and after that do not including a time frame.
  • Cost: The procedure can be expensive, and since it is often considered cosmetic, it may not be covered by insurance.

Making an Informed Decision

Choosing to undergo cosmetic facial fat grafting is a personal decision that should be made after thorough research and consultation with a qualified plastic surgeon. It’s essential to discuss your aesthetic goals, review before-and-after photos of previous patients, and understand the surgeon’s approach to achieving natural-looking results.

Additionally, candidates should consider their overall health, as certain conditions may affect the procedure’s outcome or increase the risk of complications. A detailed discussion about your medical history, expectations, and potential risks will help ensure that cosmetic facial fat grafting is a safe and effective option for you.

Generally, Dr. Steinsapir believes that fat grafting is seldom the right procedure for people. He sees 4 to 5 new consults each week for people seeking help for unsatisfactory facial fat grafting. Long term, fat grafting does not hold up well, and weight gain in the grafted fat is a long-term problem for which there is very little help. Dr. Steinsapir finds that often patients were sold on the concept of being fixed once and not needing anything else. Sadly, this is never really works out. Fat grafting is not a panacea for aging. If most cases, individuals would have been far better off never being fat grafted. For this reason, he strongly believes that the much more flexible hyaluronic acid fillers are a more versatile treatment that can be removed if it becomes satisfactory in the future.


Cosmetic facial fat grafting promises a pathway to rejuvenation blending natural results to achieve your goals. The reality does not always live up to the hype. As with any cosmetic intervention, it’s vital to approach this decision with a clear understanding of both the potential benefits and risks. By selecting a skilled and experienced surgeon and maintaining realistic expectations, patients can achieve a refreshed and youthful appearance that reflects their inner vitality and avoid regret.

Call Dr. Steinsapir now to schedule your service.

About Dr. Steinsapir

Dr. Steinsapir is a board-certified eye surgeon and fellowship trained in oculoplastic surgery and cosmetic surgery in Los Angeles and Beverly Hills where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice in Beverly Hills and also serves as a volunteer faculty at the Jules Stein Eye Institute, David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s can make a difference for you.