Both fat grafting and soft tissue fillers may be used to augment facial volume. Common sites for augmentation include lips, cheeks, tear troughs (at the junction between the lower eyelid and cheek), and around the mouth region. Many patients wish to add prominence or definition to their natural contours, while others wish to address volume loss that occurs in association with facial aging. This leads to a common question: fat grafting or fillers?

When considering fat grafting or fillers, it is important to understand key differences regarding the following:

  • Length of treatment effect for fat grafting or fillers

Fillers provide temporary soft tissue augmentation.  Length of treatment effect varies based on the type of filler and depth of injection. Hyaluronic acid fillers, for example, may last for several months or up to two years for newer products with different cross-linking.  Fillers may also last longer when injected deeply against bone and for shorter duration when injected superficially and closer to muscle action.  The depth of injection varies based on the site.  Fat grafting, which harvests a patient’s own body stores for injection at a different site, relies on establishing a new blood supply at the injection site. When revascularization is complete, the fat which has survived may lead to permanent augmentation. Some fat is generally resorbed following injection, so overcorrection up to 30% is often performed to account for this.  Since filler results are temporary, it may be injected to assess whether a patient likes a given treatment effect.  If so, fat transfer may then be considered to lead to more permanent results.

  • Recovery following fat grafting or fillers

Following soft tissue fillers, patients may return to work on the same or next day. Cold compresses may help to reduce the risk of bruising and swelling following injections. Since fat grafting is a more invasive surgical procedure, patients may require a few days downtime before returning to regular activities. I also recommend refraining from exercise for 2-4 weeks following fat grafting, depending on the site of injection and extent of surgery.  This may also reduce swelling and risk of bleeding and bruising post-operatively.

  • Discomfort following fat grafting or fillers

Discomfort is usually minimal following facial fillers. Most products have local anesthetic as an additive, which provides pain relief for a few hours post-injection.  Fat grafting surgery requires a donor site, which is most commonly the abdomen or thigh. Greater discomfort is usually experienced following fat grafting vs. fillers, although it is generally mild.  Prescription pain medication may be required for a couple of days following fat grafting.  Cold compresses are also beneficial for the first 48 hours to reduce localized discomfort at both the donor and injection sites.

  • Cost of fat grafting or fillers

It is important to consider both cost per treatment as well as long-term costs if planning to undergo routine filler injections to maintain the treatment effect.   The cost for fat grafting is higher than soft tissue fillers, since fat injections are performed in an operating room setting.  Once the grafted fat has established a new blood supply, results should be longstanding.  Repeat fat grafting may be required depending on the amount of resorption.  Although less costly per injection, facial fillers may be more expensive than fat grafting in the long-term if injections are repeated on a regular basis to maintain results.

If considering soft tissue augmentation – whether fat grafting or fillers – please contact us to discuss in more detail!