The Surgeon Minute

The Do’s and Don’ts of Fat Transfer to the Face

The Do’s and Don’ts of Fat Transfer to the Face

Regardless of our body size, weight or shape, we all have fat cells. Most of the time when we hear the word fat, our minds spring into battle mode. Fat is the enemy – unless you are a plastic surgeon. “I see fat as my friend,” says board certified plastic surgeon Dr. Brad Calobrace. “I like it because it is your natural tissue, it carries with it more than just volume, it carries stem cells and other important things. It’s the most natural thing under the skin.”

In his Louisville, Kentucky practice, Dr. Calobrace utilizes fat transfer to enhance just about every facial surgery he performs – from facelifts to eyelids. Fat acts similarly to how a facial filler acts, with the added benefit that most of the fat continues to live in its new location, meaning some of the volume restoration is permanent.

by Anne Meyer
and Brad Calobrace, MD

Placement is Key to Longevity in Facial Fat Injections

“Movement is a problem for the longevity of fat. A graft, like fat grafting, has to be stable, and get blood supply, so if it’s constantly moving, it dissipates and goes away,” explains Calobrace. For this reason, he often advises patient against doing fat transfer to the lip area. Lips are the most animated part of our faces, moving constantly as we talk and eat. Fat grafts deliver much better results in less mobile areas of the face, such as the cheeks or the jawline.

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A Little Fat Goes a Long Way

On average, about 50% of fat that is injected in the face remains living and permanent in its new location. When this is explained, a common question surgeons hear is, “If only half of it will live, shouldn’t we overfill the area to achieve better long term results?” Calobrace is quick to caution anyone with that mindset. “You have to be very careful with fat. There are only small compartments of fat in the face. You can only put it in small areas, so it’s best to be conservative, and do only what you think looks good. Very, very small amounts of fat make a big difference for my patients.” He goes on to explain that while it is on average 50% of the fat that remains, it is possible in any given case that more, or all, of the fat injected will live and remain permanently, so it’s never a good idea to overfill.

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Changing Your Mindset About Fat

While most people think very negatively about fat, everyone loves the idea of a more youthful face. When people approach Dr. Calobrace about having a procedure done to remove fat from one part of their body, he takes it as an opportunity to offer the benefits of that same fat in another area. “I would never take fat out of somebody without discussing whether we need that fat somewhere else. It’s very useful. If I’m liposuctioning anything, I may say, ‘Hey, would you like to use that fat and put it in your face, and add a little volume to your face instead of doing fillers for a while? It will create a nice gentle volume for you.’”

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