We recently received this question from a patient that was weighing the choice between fat injections and Restylane injections. Despite the long menu of cosmetic dermal filler products, every few years, the interest in fat injections as a filler treatment gains renewed interest or is promoted with a new and improved technique.
What may seem most obvious often gets overlooked – that the use of a fat injections requires harvesting of the fat. This necessitates an invasive procedure. The fat harvesting process is quite meticulous in terms of how the fat is retrieved, where it is retrieved from and also how it is placed back into the body. This procedure also involves large bore cannulas, a fat harvesting tool that can cause much discomfort.
In the best case scenario for fat harvesting and injections, and if all goes according to plan, is that a procedure that provides a natural volumizing effect may potentially last between 7 and 10 years. This may be a good option if one is in need of much volumization, and the cost of synthetic cosmetic dermal fillers would be too expensive. However, current research supports improved longevity (18 months) with the use of synthetic fillers such as Restylane and Juvederm. Semi-permanent and permanent fillers can also compete with the longevity of fat injections. For these reasons and because the harvesting is a painful, expensive and invasive procedure, we believe that dermal fillers are a great alternative to fat injections.
The potential negative side effects of fat injections include a lack of smoothness in the areas that the fat is placed. Even with the best technique, the potential for lumps is a ongoing concern. Swelling tends to be quite pronounced following the treatment which can leads to extended “social downtime.” In addition, many patients are unaware that fat will change over time – as it does in all areas of the body. For this reason, the predictability of short and long-term changes is an unknown. In contrast, it is fairly well understood how dermal fillers like Juvederm, Perlane and Restylane react over time in the body.
If prolonged lumps or nodules develop with hyaluronic acid fillers, there are methods to provide quick reversal or intervention – not so with fat injections. Also, cosmetic dermal fillers tend to be less challenging when being placed, molded and sculpted.
Another issue to be mindful of is that fat injections do not address the problem of support and structure or lack thereof. To merely add volume when one is in need of support does not lend itself to an appealing outcome. On the other hand, the newer techniques used with cosmetic dermal fillers can achieve not only volumization but structure, support, and overall shaping of the face. These techniques are much more difficult or impossible with fat injections.
There are an abundance of excellent synthetic and non-synthetic dermal fillers available to consumers. Undergoing a minimally invasive treatment with these products versus a surgical procedure may be a much better option. When fat injections are the better choice, one should be confident that the potential negative outcomes are outweighed by the potential benefits. In our opinion, that would be a very small percentage of patients.
In summary, do your research and homework. Find a practitioner that is very knowledgeable with current procedures and well-practiced in the treatment that they are proposing.