Facial fat grafting, a procedure that harvests a patient's own fat to restore volume and create a more youthful appearance, has seen a dramatic rise in popularity among women across various age groups. Once primarily sought by older patients to combat significant signs of aging, the technique is now being embraced by younger generations for its perceived natural results and preventative qualities.
Plastic surgeons note a shift away from traditional fillers, such as hyaluronic acid and Botox, with some patients dissolving existing fillers to opt for fat transfers. This trend is partly attributed to "filler fatigue," where the overuse of synthetic injectables can lead to an unnatural, augmented look. "Patients want restoration, not exaggeration," said Dr. Paul Nassif, a Beverly Hills plastic surgeon. "Fat uses your own living tissue. It also contains regenerative cells that can improve skin quality over time."
The popularity of fat grafting has also been influenced by the widespread use of GLP-1 agonists like Ozempic, which can lead to unintended facial volume loss, often referred to as "Ozempic face." Patients seeking to replace this lost volume are increasingly turning to fat transfer.
Dr. Babak Azizzadeh, a facial plastic surgeon in Beverly Hills, has observed a substantial increase in younger patients undergoing the procedure. Previously, individuals under 40 constituted about five percent of his fat grafting cases; now, they represent approximately 20 percent. "It's exploded in all age groups," he stated.
The Procedure and Its Appeal
Facial fat transfer, also known as lipofilling or fat injections, involves harvesting fat from areas like the abdomen or thighs via liposuction. This fat is then purified and re-injected into facial areas prone to volume loss, including the cheeks, temples, under-eyes, jawline, and around the mouth. The appeal lies in its use of the patient's own tissue, which is believed to provide more subtle and enduring results compared to synthetic fillers.
One patient, who underwent the procedure at age 44 after significant weight loss post-pandemic, described her face as appearing "really aged" and hollow. Fat was taken from her knees, abdomen, and thighs and injected into her nasolabial folds, temples, and under-eyes. She preferred fat transfer over fillers, citing concerns about migration and the ongoing need for repeat treatments. "I thought if I was going to invest thousands into fillers over the years and still eventually need other things in the future, I would rather do the fat transfer," she explained.
Potential Risks and Considerations
Despite its growing popularity, doctors caution that facial fat grafting is not without risks. While fat does not typically elicit the same foreign-body responses as synthetic injectables and is less prone to lumpiness, complications can still occur. Overfilling can lead to unnatural results, and unlike some fillers, fat grafting cannot be easily reversed.
Jessi Draper, a 34-year-old reality television personality, shared her negative experience after fat grafting, stating it "ruined" her life and left her lips "lumpy" after fat was transferred into them without her explicit request. Her attempts to correct the issue with further procedures were unsuccessful.
Factors such as the surgeon's technique, aesthetic judgment, and the patient's potential for future weight fluctuations can influence outcomes. Dr. Sean Alemi, a facial plastic surgeon, noted that fat cells retain the characteristics of their original location. For instance, fat transferred from the thighs might expand if the patient gains weight in that area, potentially altering the facial appearance. "If you go off of Ozempic and you gain 50 pounds or something like that, then I would really be worried that that person's face might change as a result of the weight gain," he advised.
Surgeons also consider hormonal changes, such as those associated with menopause, and a patient's age. Dr. Behrooz A. Torkian suggested that some celebrity appearances attributed to overdone fillers might actually be the result of fat grafts placed at a younger age that have since expanded. However, research by Dr. Azizzadeh indicates that fat harvested from the inner thigh may be less susceptible to significant changes with weight fluctuations or hormonal shifts, potentially minimizing long-term risks.