Q: Dr. Eppley, I have a question about paranasal implants. May I ask what do you think about fat graft to the sunken paranasal area ( and a malar implant on top)? Will fat grafts ( say inclusive of a few touch ups ) have the same effect as a paranasal implant?
A: Fat grafts by themselves will not have the same effect as paranasal implants. A solid implant on the bone can very effectively push outward on the overlying mid face tissues. (it has a more rigid structure that the tissue that it is designed to displace) Conversely, a fat graft is soft and does not have the same degree of push (augmentation) as a solid implant. The overlying soft tissue has the same structural rigidity as the fat graft so there is some rebound effect and less defined augmentation than one would think. In addition, the retention of a fat graft is unpredictable.
Thus fat injections are not a comparative ‘implant’ to that to a true paranasal implant. For those opposed to the placement of an actual facial implant, fat injections are the only other option and are not unreasonable…it just does not create the same effect as a paranasal implant.
Dr. Barry Eppley