You’ve probably seen facelift surgeons on social itemizing the procedures their patients are about to have done or have already undergone. Frequently on the list is fat grafting. The procedure has long complemented facelifting, playing a strong supporting role to the tissue-repositioning operation. Recently, though, fat transfer seems to have become an almost mandatory part of facial rejuvenation surgery. A star in its own right.
Which may be why I’ve been getting so many questions about fat grafting, especially following my latest Voice column, featuring Christian Jacob, MD, who is a bit of a surgical unicorn in many ways, including by nature of the fact that he doesn’t offer facial fat grafting, deeming it too unpredictable. Some of you were a bit confounded by this fact, because on social, it seems like fat is part and parcel of the facelift. (Fat transfer can also be done as a standalone procedure; some surgeons perform it under local anesthesia with patients awake.)
While fat grafting has become ubiquitous, there isn’t a tremendous amount of evidence elucidating the particulars of the procedure—best practices for harvesting, processing, and injecting; fat survival rates with one method versus another; or how and to what degree the stem cells in fat might improve our skin and deeper tissues.
In the absence of conclusive data, we have an abundance of clinical anecdotes and wildly variable retention rates (ranging from 25% to 80%), which reflect differences in both surgeons’ techniques as well as patients’ biology (factors like age, BMI, menopausal status, and more).
While interviewing surgeons for an upcoming story, I was struck by the spectrum of opinions on facial fat grafting. Since, per usual, I couldn’t work every insight into the piece I was writing, I figured I’d share the surplus here.
If you’ve been wondering which strategies can improve fat cell survival, or if those fancy filtration systems truly affect outcomes, or why your surgeon doesn’t offer fat injections separate from face and brow lifts, you’ll want to keep reading.
