Which Is Better – Synthetic Fillers or Fat Injections?
Q: Dr. Eppley, I am interested in getting some volume back in my face. I lost a fair amount of weight over the past two years and my face has become quite gaunt. After doing a lot of reading, I know that there are the options of either some type of injectable filler or using your own fat. There doesn’t seem to be any consensus as to which is best. What is your opinion?
A: The development of synthetic fillers has created a whole new field of aesthetic medicine, mainly for facial rejuvenation. They are understandably hugely popular because of their instantaneous effects. While some last longer than others, in the end they are all temporary fillers. This issue only becomes truly relevant with major facial volumization is desired. The issue is simply one of cost. Given the volume of synthetic filler needed and the time that they last is the cost worth it? That, of course, is an individual question but the cost:benefit ratio does come into play for most patients.
Fat injections do not suffer from volume concerns and are more cost effective when considering the volume that is capable of being injected. Fat also has the added benefit of providing some stem cells as well although what their role is and how much they contribute to fat graft survival and overall tissue rejuvenation is still a matter of some debate. While fat grafts have the potential for long-term survival, their retention is not completely assured. Fat grafting procedures are a surgical procedure, however, and need to be performed under either local anesthesia or IV sedation depending upon the volume needed.
In the end, both synthetic fillers and fat grafts have their advantages and disadvantages. When it comes to substantial facial filling as in the gaunt face, fat grafting has more advantages as long one is willing to commit to more than an office procedure with some downtime.
Dr. Barry Eppley
A detailed description and pictures of your concerns allows for the most informed response.