Q: Dr. Eppley, We have discussed using an implant for my infraorbital-malar augmentation, but I was wondering if fat grafting could be an option as well. I think I would prefer the fat grafting, it seems less invasive and more natural. I attached some photos of my face. Also, I saw that fat grafting could be used for the chin and jaw. I think having a chin that protrudes more would make my nose seem less prominent. I was also curious about having a wider, more square jaw with fat grafting. However, I am mostly concerned with just my cheek/eye area.
Thank you for your help,
A: Fat grafting is a natural body graft but has major issues of initial survival and long-term retention. In your face probably close to 0% of the fat would survive because you have very thin tissues. It is also prone to irregularities and clumping in the eye area as it does not get distributed in a smooth linear fashion. Fat also is a soft material so it does not give a hard push on the tissues and will just make everything more round and soft looking.
In short, fat grafting and implants are not interchangeable facial techniques. They not only are done differently but have very different aesthetic outcomes and long-term implication.
But there is no harm in trying fat first…then you will know for yourself.
Dr. Barry Eppley