What Do You Think About Fat Transfer During Facelift Surgery?

Q: Dr. Eppley, Fat transfer to the face is highly unpredictable and have a high cell mortality rate. To avoid hematomas, calcifications, lumpiness and infection that is often attributed to fat transfer to the face and because the face is so visible to the public world, most plastic surgeon do NOT recommend fat transfer to the face. Some plastic surgeons comment that fat transfer to the face is more trouble in the long run than what it is worth. By the 1 year mark, most patients are extremely unhappy with the results. What is your opinion about fat transfer to the face during a facelift procedure?

A: Your perception about fat grafting to the face seem to be contrary to what its use is in aesthetic facial surgery amongst most surgeons. It is widely used as an adjunct in facelift surgery as the current perception is that volume loss is a significant component of the facial aging process. And facelift surgery is not a volume addition procedure but a tissue redistribution[rearrangement directed surgery. Fat grafting therefore seems logical to add volume back to what a facelift of any form can not do. That being said the issues with fat grafting are more about who benefits from it and what is its longevity…the answers to which are not scientifically known. But because it is an autologous procedure with intraoperative harvest and immediate put back into the patient and whose main ‘complications’ are resorption and lack of volume retention its clinical use precedes scientific investigations like a drug or device to full evaluate safety and effectiveness.

Dr. Barry Eppley

World-Renowned Plastic Surgeon