Face Rejuvenation with Fat Grafting

I. What is Facial Fat Grafting?

Facial fat grafting is one of the most effective and widely used facial rejuvenation treatments today. This minimal invasive technique uses autologous fat that is carefully harvested, purified, and injected into targeted areas of the face to restore volume and smooth wrinkles.

Client before and after undergoing fat grafting to the cheek and temple areas

 Client before and after undergoing Facial Fat Grafting, alarplasty, rhinoplasty, blepharoplasty, and brow lift.

Client 1 month after undergoing Fat Grafting to the temple, midface, and lower eyelid hollows.

Client before and after undergoing the Periorbital Fat Grafting

Before and after photos of a 70-year-old client who had autologous fat grafting for nasolabial folds,  facelift, brow lift, and lower eyelid surgery.

 Spectacular transformation of a client in their 70s after undergoing facelift, eyebrow lift and lower eyelid surgery at Dr. Thai

Before and after photos of a client in their 60s undergoing facelift with double eyelid surgery, lower eyelid surgery and fat grafting for nasolabial folds.

Collagen Thread Lift – Safe Rejuvenation with Dr. Thai at Viet My Plastic Surgery Hospital

Understanding the Facial Aging Process

A youthful face is typically characterized by fullness, smooth skin, and firm contours. However, aging leads to gradual structural changes:

• Loss of Collagen and Elastin: Reduces skin elasticity and firmness, and causes wrinkles and skin laxity, especially on the forehead, crow’s feet, and nasolabial folds.
• Fat Atrophy and Dehydration: Leads to volume loss and hollow appearance, most noticeable in the cheeks, temples, and under-eye areas
• Weakening of Muscles and Ligaments: Causes sagging of facial tissues, results in eye bags and loss of jawline definition

Illustration of the aging process

II. Facial Rejuvenation Approaches

Modern anti-aging treatments can be divided into two main groups:

1. Lifting Procedures: The doctor removes excess skin and tissues, simultaneously lifting and securing them in a more youthful position. For early-stage aging or patients who wish to avoid visible scars, minimally invasive or non-invasive lifting techniques may be applied.

2. Volume Restoration: This approach restores lost volume using fillers, implants, or autologous fat grafting. Among these, autologous fat grafting is considered the superior option, as it uses the patient’s own tissue, providing natural and long-lasting results.

III. Benefits of Facial Fat Grafting

The face contains multiple fat compartments that support underlying structures and define facial contours. Facial fat grafting restores volume by replenishing areas where fat has been depleted with healthy fat cells, effectively reversing visible signs of aging.

IV. Treatment Planning

The face consists of two main fat layers: superficial fat (beneath the skin) and deep fat. Each layer plays a distinct role and ages differently. Understanding these layers allows for a more precise and individualized treatment strategy:

- Superficial fat layer: consists of small fat compartments situated just beneath the skin and evenly distributed throughout the face. As aging occurs, depletion of this fat layer, together with reduced collagen and elastin levels, weakens the skin’s outward structural support, while the inward pull of the facial muscles persists. This imbalance leads to the development of deeper wrinkles. Fat grafting into the superficial layer can help improve the nasolabial folds, forehead lines, and brow region. It may also be combined with Botox to decrease muscle activity and further soften dynamic wrinkles.

- Deep fat layer: Located primarily in the cheeks and around the orbital area, providing structural support for the face. When this layer diminishes, the face appears hollow, gaunt, and aged.

Due to the complexity of facial fat compartments, the surgeon must carefully assess the face to determine priority treatment areas and estimate the appropriate volume of fat. This targeted approach ensures optimal aesthetic outcomes while maintaining cost efficiency.

Distribution of facial fat compartments

V. The Procedure of Facial Fat Grafting

Facial fat grafting is a relatively short procedure, typically lasting around one hour, and can be combined with other procedures such as a facelift or midface lift. This procedure is performed under local anesthesia and includes 3 main steps:

• Fat harvesting: Fat is gently extracted using liposuction technique in the abdomen or thighs.
• Fat purification: Harvested fat solution is processed to isolate the healthiest fat cells for grafting.
• Fat injection: The doctor injects fat into pre-determined facial compartments using precise layering techniques. To enhance fat survival, stem cells, PRP (platelet-rich plasma), or PRF (platelet-rich fibrin) may be combined to improve treatment outcomes.

The procedure of fat grafting

VI. Post-Operative Care and Recovery

To ensure optimal recovery, patients should follow medical instructions carefully:

• Maintain a healthy diet and lifestyle; attend all scheduled follow-up appointments
• Take prescribed medications (pain relief) as directed
• Sleep with your head elevated
• Apply cool compresses during the first 48 hours to minimize swelling (avoid excessive cold)
• Wear compression garments (24/7, except when showering) for the first 2 weeks to stabilize the graft and support new blood vessel formation.

Risks

Due to the complexity of facial anatomy, potential risks may include:

• Injury to blood vessels or nerves
• Uneven results due to overcorrection or undercorrection

However, these risks can be significantly minimized when performed by a highly experienced and skilled doctor.

* The result achieved also depends on each individual's physiology.