Are Facial Fat Injections Better Than Synthetic Injectable Fillers?

Q: Dr. Eppley, I want to know about facial fat injections. I know a 24 year old who is unsatisfied with her facial appearance. She weighs 118 lbs, and is 5’6”. She does have a lot of facial fat especially in her lower cheek and the areas around the mouth. Ironically, this makes her mouth look fat. She has had braces, but is still unsatisfied because she says that the most noticeable part of her face is still her mouth. She is pretty, but she does not smile because the “excess skin makes creases” at the sides of her mouth. I did a little research and deduced that she has noticeable perioral mounds due to a lack in facial volume. Do you offer fillers such as sculptra and radiesse, or would fat transfers to the cheeks be possible and could this possibly improve her appearance to a noticeable extent? She is doing all she can to avoid getting cheek implants. She is so young to be unhappy about her face.

A: Some of what you ate saying is a it contradictory. Perioral mounds are excessive collection of fat just to the sides of the mouth. They do not occur ‘due to a lack of volume’ as you have described. You may have mispoken in that regard. Thus I am not sure your friend had too much fullness at the perioral mounds or a lack of it.

Injectable fillers are always a good first step to try if one is uncertain whether the addition of volume is the correct facial approach. If one is certain that the addition of volume is needed, facial fat injections would be a better approach as it has the potential to offer some permanency while synthetic fillers do not.

Dr. Barry Eppley

Indianapolis, Indiana