At some point, we all look in the mirror and realize that aging has made us look a little less like what we envision ourselves to be. A few extra wrinkles here and there, some sunken hollows, and suddenly we don’t recognize the person staring back at us in the mirror. Thankfully, years of aesthetic advances mean that there are treatment modalities available that can help to reverse some of the aging signs on our face.
Today, we will be discussing dermal fillers vs fat grafting. In a nutshell, dermal fillers are natural hyaluronic acid fillers which come ready packed in syringes. Fat grafting or fat transfer is a procedure where your very own fat is extracted from areas of unwanted fat, purified and then reinjected back to your face.
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If you’re more concerned with deep wrinkles, but still want to improve volume, facial fillers may be a better choice.
Injectable fillers come in FDA approved brands such as Juvéderm Voluma®, Restylane® and Boletero. When these hyaluronic acid fillers are injected into the face, they add volume, improve contouring, and fill in static wrinkles such as nasolabial folds.
Natural hyaluronic acid fillers are not permanent, and depending on your needs, this can be a pro or a con. They have temporary results that typically last a few months to a year, depending on the type of filler used, the target site of injection and total volume administered. Downtime of injectable fillers are minimal, occasionally there can be some pin prick marks and bruising, though the latter occurs only occasionally and is quickly resolved as this is a minimally invasive procedure. Procedure time takes about 30 to 60 min, and patients can go back to work and continue with normal activities after.
Pros of Injectable Fillers
- Fast and non-invasive treatment. Treatment is done under local numbing cream and is comfortable for most patients.
- Several choices in fillers to achieve different goals. Significant wrinkle reduction and volume improvement, particularly in the cheeks and lips
- Very little or no downtime needed
- If you don’t like the results, hyaluronic acid fillers can be simply dissolved away with an enzyme called hyaluronidase.
Cons of Injectable Fillers
- Not permanent (generally lasts a few months up to a year)
- Costs of ongoing treatments can add up as you will require a top up as the fillers dissolve over time.
- If you have significant volume loss, the cost can add up as facial fillers are usually charged by the volume used.
Facial Fat Grafting
If your main concern is loss of volume in the face, facial fat grafting (also known as fat transfer) is likely a better choice than facial fillers, especially if more volume is needed around the eyes, cheeks, and jawline. Since you are using your own fat, the price of the procedure is the same regardless of the volume of fat extracted and grafted. Fat grafting has been shown to last longer than fillers in terms of maintaining fullness.
To get a better idea of how fat grafting works, think of a balloon. When it’s inflated and full, it’s smooth. But when the air is let out of the balloon, it’s loose and wrinkled. Fat grafting “inflates” the skin by filling it again with your own fat. Fat is also a very rich source of stem cells, which may help to improve the appearance of the overlying skin.
During the fat grafting procedure, tiny amounts of fat are removed from your abdomen or thighs. This shouldn’t be confused with procedures such as liposuction since such small amounts of fat are removed. The fat is purified and then injected into the areas of your face that need filling using a microdroplet technique, which simply means that only small droplets of fat are injected at a time. This technique results in a smoother appearance. Many experts believe that fat grafting’s effectiveness is due to a stem-cell response within the skin. More than one fat grafting treatment may be needed to achieve your aesthetic goal, but the results typically last for years. Many patients require no future treatments.
Pros of Fat Transfer
- Can be placed anywhere around the face
- Results last longer
- Fat may carry stem cells that produce growth factors for improved tissue condition
- Use of your own fat to fill the face. If large volumes are needed, this may end up to be more cost effective.
- Improved skin texture and tone over time.
Cons of Fat Transfer
- Invasive and technically demanding compared to dermal filler injections
- The body may absorb some fat, meaning not all fat transferred can survive in the long run
- May require additional procedures to obtain desired results
- Results may fluctuate when you gain or lose weight over time as the fat cells respond to weight gain and loss.
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When it comes to facial rejuvenation treatments, does it matter which treatment you try? Yes — it does matter. Each treatment and product is specially created to enhance the face in different ways. You must choose your treatment based on the benefits it can offer your aesthetic needs and goals. You can also use a combination of treatments to help you attain the best results. It is possible for you to undergo fat transfer for general volume loss, and then have smaller facial filler treatments as smaller boosts over time.
Dermal fillers, being a non-surgical procedure, is more desirable for people who don’t want too much downtime. It is ideal as a lunchtime rejuvenation treat as patients can get the facial fillers done during their lunch hour and go back to work after. Dermal fillers do not require incisions or general anesthesia; the procedure is usually done with a numbing cream. Thus, long-term recoveries are not necessary. You may experience minimal swelling after the injection period since your body will adjust to the filler, but the sensation will subside soon after the procedure. The amount of swelling post procedure is also minimal compared to fat grafting procedures.
Fat transfer, on the other hand, is a surgical procedure which involves two distinct steps. Your plastic surgeon will collect the fat needed from other parts of your body before performing transfer injections onto your face. The fat is usually harvested from the thighs or buttocks through liposuction: a small incision or opening will be made where a small tube will be inserted. The tube will be gently moved back and forth to allow fat deposits to disperse under your skin until removed. Once enough fat has been collected, your surgeon will prepare it for injectable purposes.
Since fat transfer injections are a surgical procedure, more recovery time is needed compared to facial fillers. Stitches or medical tape are necessary to seal the incision site. You may experience swelling or discomfort around the fat harvesting and injection sites. Recovery should last about a week before you may resume regular activities.
Though facial fillers and fat transfer treatments provide effective and immediate results, they do have some advantages over the other. For example, your body will absorb some fat deposits transferred to your face, which is why surgeons will typically transfer more fat than necessary. As a result, your face may appear more swollen than expected. However, once you fully recover from the procedure, your results from a fat transfer will appear more natural and apparent.
Regarding longevity, the results you get from fat transfers are longer lasting than dermal fillers. Once administered, most of the fat will remain in place to maintain consistency in shape and appearance. Dermal fillers, however, require repeat treatments to maintain results. How often you will need dermal filler injections will vary depending on the type of filler and how your body reacts to the substance. Some patients need new dermal filler injections every three or four months, while others will only need a follow-up procedure once or twice a year. Some patients can preserve their results for much longer, though it is not common.
Rejuvenate Your Facial Features
Going to a plastic surgeon does not necessarily mean extreme changes, like complete face-lifts or walking out with triple the lips you went in with. There are ways to achieve subtle, beautiful results. Always speak to your surgeon to ensure you have a clear understanding of the procedure before starting any treatment.