Can I Injectable Fat Grafting Be Done For Small Skull/Head Augmentations?

Q: Dr. Eppley, I really appreciate the effort you put in all your articles and case studies. I am interested in back of the head augmentation. Since I only would need a small amount of additional volume for a more aesthetic and rounded head shape, I think your article of using fat grafting (especially for augmentation of the area lower than the nuchal line) is very interesting.

Since you and also other plastic surgeons say that fat grafting is not a permanent solution in this area, I wonder if there are any patient cases, where x % of the transfered fat really stayed at the desired positions for many years? I would be extremley happy, if it could be a permanent solution. Even if a 2nd fat transfer would be necessary. I attached an image which shows the little volume increase I desire. I am looking forward to your reply. Thank you very much in advance!

A: I think the use of injectable fat grafting for small areas of head shape deficiencies is a viable low risk non-incisional approach to select head augmentations. Its potential success is based on two factors, 1) how much fat survives (which is largely known by 6 weeks postop) and 2) how much donor fat is available for harvest. In young male patients I am more focused on #2 than #1.

In my experience with injectable fat grafting to the scalp, which is where it is placed for head augmentations, it generally works fairly well for low volume needs. Its long term retention (meaning years or a lifetime) I can not say nor have ever commented on because it is unknown. One should not confuse survival vs retention as they are two different fat fate issues.

Dr. Barry Eppley

World-Renowned Plastic Surgeon