Facial Fat Grafting

Facial fat grafting, also known as lipostructure or autologous fat transfer, involves harvesting fat from a donor area of the patient (abdomen, thighs, saddlebags) and re-injecting it into the face to restore volume, correct hollows, or improve skin quality. This technique is suited to patients seeking natural facial volumisation without synthetic products — for example to soften nasolabial folds, hollow dark circles, temples, or to restore cheek volume.

The goal is a natural, harmonious result adapted to each patient's anatomy and expectations. The information below is intended for general guidance and does not replace a personalised medical consultation.

The Different Techniques

Several approaches exist for facial fat grafting. The choice depends on the area to be treated, the desired volume, the quality of available fat, and the strategy defined during the consultation with the surgeon.

Fat harvesting

• Gentle liposuction: harvesting using fine cannulas under local anaesthesia with sedation or general anaesthesia depending on the extent of the procedure and any associated procedures.
• Common donor sites: abdomen, flanks, inner thighs, or knees.
• Goal: to collect adipocytes and stromal cells using an atraumatic technique to preserve graft viability.

Adipose tissue processing and purification

• Gentle centrifugation or decantation to separate fat cells from fluids and impurities.
• Some techniques add filtration or the use of fractionation (microfat, nanofat):
• Microfat: small-quantity grafts for volume restoration (cheeks, temples).
• Nanofat: very fine preparations aimed at improving skin quality (texture, trophicity) rather than adding volume.

Re-injection / grafting

• Re-injection as multiple micro-grafts distributed across different planes (subcutaneous, sub-aponeurotic) to promote engraftment, vascularisation, and graft survival.
• Technique dispersed in thin layers to limit resorption and achieve a natural appearance.
• Possible addition of complementary treatments (PRP) depending on the indication and pre-operative discussion.

Pre-operative Consultation

The consultation with the surgeon is essential and personalised. It includes:

• Medical history: past history, current medications, expectations, and motivations.
• Clinical examination: skin quality, volume deficits, possible donor sites, pre-operative photography.
• Discussion of options: most appropriate technique (microfat, nanofat...), anaesthesia, hospitalisation (day surgery or one night depending on the case).
• Prescription of any necessary tests: blood panel, tests depending on general condition.
• Provision of a written quote and information document.
• Mandatory reflection period: a minimum 15-day period applies before any aesthetic surgery.
• Collection of informed consent and explanations of risks and possible result evolution.

Procedure

• Anaesthesia: local with sedation or short general anaesthesia depending on the combination of procedures and patient preference.
• Duration: variable, generally between 1 and 3 hours depending on the extent of harvesting and re-injections.
• Main steps: marking and preparation of areas, gentle liposuction fat harvesting, adipose tissue processing, re-injection as micro-grafts, dressings.
• Setting: procedure performed in an accredited facility (operating theatre) with traceability of samples and devices, adherence to aseptic and safety rules.
• Discharge: often day surgery (same-day return) or one night's hospitalisation depending on the extent of the procedure.

Post-operative Recovery

• Swelling and bruising: common and generally resolving within 1 to 3 weeks.
• Pain: generally moderate, relieved by prescribed analgesics.
• Local care: simple dressings, possible compression garment on the donor area.
• Initial result: visible quickly, then evolving as swelling resolves and grafts stabilise.
• Resumption of activities: light work often possible within 3–7 days depending on discomfort; intensive physical activity generally not recommended for 3 to 6 weeks.
• Follow-up: scheduled post-operative appointments to verify healing, graft acceptance, and to discuss any complementary procedures.

Results and Limitations

• Evolution: results develop progressively. Some fat cells may be resorbed in the weeks or months following the procedure; stabilisation generally occurs after several months.
• Variability: the final volume and graft longevity differ according to tissue condition, age, lifestyle, and technique used.
• Touch-ups: one or more complementary sessions may be necessary to optimise the result in some cases.
• Durability: fat that successfully engrafts is in principle long-lasting, but the face continues to evolve with ageing and weight changes.

Risks and Complications

Risks will be detailed at the consultation; the most frequent or important include:

• General risks: bleeding, infection, allergic reaction to anaesthetic products.
• Specific complications: asymmetry, surface irregularities, partial or uneven graft resorption, localised necrosis (rare), oil cyst formation.
• Rare but serious complications: fat embolism (very rare in facial practice but important to know about), requiring specialised management.
• These complications are generally infrequent; they will be explained and discussed during the consultation.

Alternatives and Non-surgical Options

• Hyaluronic acid injections: temporary volumisation for moderate volumes and localised touch-ups; limited duration (a few months to 1–2 years depending on the product).
• Biostimulator injections (hydroxyapatite, poly-L-lactic acid): stimulate collagen to restore structure, without added fat volume.
• Aesthetic medicine treatments: peels, laser, micro-needling, PRP to improve skin quality.
• Thread lifts or surgical lift: alternatives for skin tightening when laxity is predominant.
• Each option has indications and limitations; the choice is made following examination and discussion of the desired goals with the surgeon.

FAQ (Frequently Asked Questions)

Is facial fat grafting painful? Pain is generally moderate and controlled by analgesics. Discomfort comes mainly from swelling and bruising in the first few days.

How long is the hospital stay? Most procedures are performed on a day-surgery basis (same-day return). In some cases, one night's hospitalisation may be offered.

Are there visible scars? Incisions for liposuction and re-injections are very short (a few millimetres) and discreet. They fade quickly.

Is it necessary to lose weight before the procedure? Significant weight changes after the procedure may alter the result. The surgeon will discuss appropriate weight balance before surgery.