What is fat transfer to the face?
Facial fat grafting, the medical term for fat transfer to the face, restores the youthful volume that aging and weight loss take from the face and fills deep grooves with your own fat. A face ages by emptying as well as by sagging: the temples and the hollows under the eyes deepen, the cheeks flatten, and the folds beside the nose and mouth cut deeper. A lift moves tissue that has dropped; fat transfer replaces tissue that is gone, with living cells harvested from the belly, a thigh or a flank and layered into the face through tiny hidden incisions. Because these are live cells, the result lasts longer than traditional fillers such as Juvederm and Restylane, and because it is your own tissue it looks softer and more natural. For younger patients the same fat can accentuate the cheekbones or reshape the midface.
Who is a good candidate for fat transfer to the face?
The test is lost volume rather than age: a face that looks tired in flat light, hollows that filler has been refilling for years, or a face that emptied after a large weight loss. Dr. Cat weighs age, health, emotional well-being and expectations, and plans for the whole face, so the cheeks match the eyes, the forehead and the neck.
You may be a good candidate if
- Your temples, under-eye hollows, cheeks, lips, jawline or nasolabial folds have lost volume, and the skin over them still has tone
- You have had filler in those areas for years and want a result that stays
- You have a little fat to spare on the belly, a thigh or a flank
- Your weight is stable, and you expect a rested version of your own face
Not yet, or a different plan, if
- You smoke and cannot stop: smokers have a much higher risk of wound-healing problems, and Dr. Cat requires two months to a year without smoking, depending on your history
- Your cheeks and jowls have dropped as well as deflated: fat alone fills a face that still hangs, so a lift with fat added is the plan
- You are very lean, with no donor fat: filler is the answer
- Your weight is still changing; aspirin, anti-inflammatories, alcohol and herbal medications stop two weeks before surgery
- Puffy bags rather than hollows under the eyes: a bag is fat that has pushed forward, and a lower eyelid lift treats it
Fat transfer under the eyes
Fat grafting under the eyes treats the tear trough, the hollow that runs from the inner corner of the eye across the top of the cheek. The skin there is the thinnest on the body, about half a millimeter, so as the fat beneath it thins the groove deepens and casts the shadow that reads as dark circles. Fat transfer under the eyes fills the groove with your own tissue, in very small amounts and fine layers, so the lower lid and the cheek become one smooth surface.
A hollow and a bag are different problems. A bag is fat that has pushed forward from behind the eye; filling beneath it makes the eye heavier, so a bag is treated with a lower eyelid lift, which Dr. Cat performs herself, and when a hollow sits beneath a bag the two are treated in one surgery. Under the eyes she is conservative on purpose: the skin is too thin to hide a lump, and the fat that takes is permanent, so she places enough to fill the hollow and no more. Filler under the eyes lasts about 12 to 18 months; the fat that survives stays. Our post on under-eye bags explains puffiness against shadows.
Fat transfer to the cheeks and midface
The cheek is where lost volume shows first and where restored volume does the most: fat over the cheekbone lifts the light back onto the face, and fat in the midface below it softens the fold to the nose and takes the tired look out of the eyes. For older patients, fat transfer to the cheeks restores the fullness that age and weight loss took; for younger patients, Dr. Cat uses the same fat to accentuate the cheekbones or reshape the midface, layered in fine passes at several depths so the cheek reads as one smooth curve.
Fat transfer to the temples and brow
As the temple empties, the tail of the brow drops with it, the eye looks smaller and the upper face looks drawn. Fat transfer to the temples restores the gentle curve between the brow and the hairline and supports the outer brow; a broad, flat surface needs an even layer rather than a single deposit, which is what Dr. Cat's layering technique is for. If the brow itself has dropped, a brow lift, which our board-certified facial plastic surgeon performs, is the plan, and Dr. Cat tells you which at the consultation.
Fat transfer to the lips
Fat transfer to the lips adds fullness with your own tissue instead of a syringe repeated every six to twelve months, the time lip filler lasts because the lips have a high blood flow. Dr. Cat places the fat in fine threads along the body of the lip to keep its shape; her rule for lips, with fat as with filler, is naturally fuller, never the overfilled "duck" look. Filler in the lips at the practice is injected by Dr. Cat herself, so a patient who wants to preview fuller lips before committing to fat can start there.
Fat transfer to the jawline, chin and nasolabial folds
Along the lower face, fat transfer does three jobs. In the nasolabial folds and the marionette lines it fills the grooves the descending cheek carves beside the nose and mouth. In the hollow in front of the jowl it restores the line of the jaw, so an early jowl reads as one straight jawline again; our page on sagging jowls explains when a lift rather than filling is the answer. On the chin and along the jaw it adds definition where the bone has lost volume or was never prominent.
Fat transfer vs filler
Both restore volume, and the practice offers both. Filler is a hyaluronic acid gel (Juvederm or Restylane), injected in the office in 30 to 60 minutes with no downtime, $1,250 per syringe, reversible with hyaluronidase, and lasting months to a year or more: about 6 to 12 months in the lips, 12 to 18 in the cheeks and under the eyes. Fat transfer is a surgery with a recovery, paid for once; the fat that survives is your own living tissue and is permanent, and one harvest treats several areas. Dr. Cat prefers fat for lasting volume, because it lasts longer than traditional fillers and looks softer and more natural; filler remains right for one small area, a first try, or a patient with no donor fat. At the practice, filler in the lips, the nasolabial folds and the neck lines is injected by Dr. Cat, and filler in the cheeks, under the eyes, the temples, the jawline and the chin by our facial plastic surgeon; read about facial fillers.
How Dr. Cat does it
Dr. Cat is a board-certified plastic surgeon who completed two surgical residencies, one in head and neck surgery, microvascular and facial reconstructive surgery, and advanced training in general plastic and reconstructive surgery, Harvard-educated and UCLA trained, in private practice in Beverly Hills since 2010. She developed a special multi-stage technique for fat transfer that creates ideal grafts and natural, long-lasting results.
The harvest: her own liposuction, no heat devices
The fat comes from one or more discrete areas where you have a little to spare, usually the belly, a thigh or a flank, through incisions of a few millimeters. Dr. Cat harvests it with the same tumescent liposuction she uses for body contouring: thin cannulas moved gently and evenly, every pass by her, and never a laser, Vaser or other heat device. The fat is living tissue, and how gently it is harvested decides how much survives; the donor area keeps a thin cushion of fat under the skin so it stays smooth.
Processing: how the fat is prepared, and what microfat and nanofat mean
Harvested fat is a mixture of fat cells, fluid, blood and oil, and only intact fat cells belong in the face; Dr. Cat gently washes the fat and prepares it into the grafts her technique calls for. Microfat is fat broken into fine particles that pass through a very thin cannula, for thin-skinned areas such as the under-eye hollows and the lips; nanofat is fat emulsified until few intact cells remain, used for skin quality rather than volume. How the fat is prepared for your face is decided at your consultation.
Placement: the layering technique through tiny incisions
Through tiny incisions hidden in the creases of the face, Dr. Cat places the fat with a meticulous layering technique, many fine passes at several depths and from several directions, so every small deposit sits next to living tissue that can give it a blood supply. A thread of fat surrounded by tissue takes; a large lump does not. The layering keeps the result smooth and lets her treat several areas in one session. Every incision is closed with small sutures, and the scars, a few millimeters long, are nearly invisible.
Anesthesia, surgery day and one surgery per day
For your comfort and safety Dr. Cat recommends general anesthesia, with a board-certified physician anesthesiologist, in her QUAD A accredited surgery center on Rodeo Drive; local anesthesia is possible but much less comfortable, because the harvest is a liposuction. She also places a numbing solution in the face, so you wake comfortable and most patients need only Tylenol. The surgery takes up to two to four hours by the number of donor areas. Dr. Cat schedules one major surgery per surgical day and performs every step herself, and you go home the same day with someone to stay with you.
Inside Dr. Cat's Beverly Hills surgical suite: her low-pain surgery approachCombining fat transfer to the face with other procedures
With an eyelid lift
An eyelid lift, which Dr. Cat performs herself, treats the fold that hoods the upper lid and the bags beneath the lower one; fat transfer treats the hollow beneath the bag and the flattened cheek. Many patients need both, and Dr. Cat plans them as one surgery with one recovery; our page on hooded eyes explains how to tell a fold of skin from a hollow.
With rhinoplasty
Patients planning a rhinoplasty with Dr. Cat sometimes add fat transfer to the cheeks or the chin, because a nose is judged against the face around it. Whether the combination fits one surgical day is decided at the consultation.
With liposuction, a tummy tuck or a Brazilian butt lift
If you are already having liposuction, a Brazilian butt lift or a tummy tuck with Dr. Cat, the fat for your face comes from the same harvest and the transfer is added to that quote at her $11,000 fee. Fat transfer always goes with liposuction, because that is where the fat comes from: a patient who wants only her face treated still has a liposuction of one area, so the donor area is chosen with care.
With a facelift or neck lift
With a facelift or neck lift, which our board-certified facial plastic surgeon performs, the fat transfer is planned and quoted with the lift.
Fat transfer to the face recovery, day by day
Here is what recovery looks like for most of Dr. Cat's patients: minimal pain, very little bruising, and a donor area that follows her liposuction recovery.
- The night of surgeryHome a few hours after waking, with someone to stay the night. The face feels tight and looks fuller than it will; the donor area is sore under its compression garment. Tylenol is usually all that is needed. Sleep with your head raised, with no pressure on the treated areas.
- Days one to threeSwelling peaks and starts to fall. Bruising, when there is any, is usually very minimal. No rubbing, massage or sleeping face-down: the grafts are settling into a blood supply.
- One weekMost of the swelling and bruising has resolved. Most patients resume normal activities within a week or two.
- Two weeksMost patients are back at work. Scar treatment starts with the products Dr. Cat provides, moderate exercise such as walking or a stationary bike resumes, and the sun stays off your face.
- Four to six weeksVigorous exercise such as jogging resumes at four weeks. The final result shows at about a month, once the swelling has gone. The garment over the donor area comes off at six weeks, as after any liposuction with Dr. Cat, with no lymphatic massage.
- Three to six monthsThe fat that has taken has its own blood supply and is a permanent part of your face; the donor area's contour keeps refining.
- One yearThe scars have faded completely. The grafted fat ages with your face and follows your weight; a stable weight and sun protection protect the result.
How long does fat transfer to the face last?
The fat that survives lasts for good. Filler is broken down over months; grafted fat that takes a blood supply is living tissue, so it becomes a permanent part of your face, ages with it, and follows your weight, fuller when you gain and slimmer when you lose. Some of every graft does not take and is absorbed in the first weeks, which is why the result is judged at about a month rather than on the day. In Dr. Cat's experience more than 80 to 90 percent of the transferred fat survives, which is why her patients rarely need a second round. A stable weight, sun protection and not smoking protect the result.
Fat transfer to the face before and after: what to look for in photos
For facial fat transfer before and after photos, one question comes first: does the face look rested, or filled? Look at the three-quarter view, where the cheek and the under-eye hollow show; in a good result the lower lid and the cheek are one smooth surface with no line, lump or puffiness. The after photo should be the same person with the same smile, only less tired, and dated a month or later, because a face at one week is swollen. Dr. Cat shows fat transfer to the face before and after photographs of similar patients at your consultation, and the practice's face and neck before and after gallery shows its facial results by procedure.
Fat transfer to the face gone wrong: what can happen, and how Dr. Cat avoids it
Fat transfer to the face is a liposuction and a graft, and when it goes wrong it usually goes wrong in one of five ways. Here is what can happen and what Dr. Cat does to prevent it.
What can go wrong
- Over-filling: too much fat at once, so the face looks heavy or filled; because the fat that takes is permanent, correcting it means a small liposuction of the face
- Lumps: fat placed in large deposits instead of fine layers does not take evenly, and a deposit that dies becomes a firm nodule or an oil cyst
- Asymmetry, from uneven placement or uneven survival between the two sides
- Fat that does not take: when too much of a graft is absorbed, the volume falls short and a second session is needed
- Infection, prolonged swelling or bruising, numbness around the incisions, and irregularities at the donor area
- The rare vascular risk of any facial injection: fat injected into an artery can block the blood supply to the skin or, very rarely, to the eye
- Anesthesia risks, which the board-certified anesthesiologist reviews with you before surgery
How Dr. Cat avoids them
- A gentle harvest with thin cannulas and no heat devices, every pass hers, so the fat arrives alive
- Her multi-stage technique: fat gently washed and prepared into ideal grafts, then placed in many fine layers at several depths, never as a large deposit
- Conservative volumes, above all under the eyes: enough to restore, never so much that the face reads as filled
- Slow placement in fine threads with a detailed knowledge of the facial arteries; she has seen what filler placed in dangerous areas does, and fat follows the same rules
- Careful patient selection: smoking stopped, blood thinners and supplements stopped two weeks before, and a stable weight
- A board-certified physician anesthesiologist in her accredited surgery center, one major surgery that day, and follow-up visits through the first months
How much does fat transfer to the face cost in Beverly Hills?
Dr. Cat's surgeon's fee for fat transfer to the face is $11,000, one flat fee for the whole face however many areas are treated. The fat has to be harvested by liposuction, priced at her liposuction rates as surgeon's fees: $10,000 for one donor area on its own, or $6,500 to $7,500 per area when two or more areas are treated. The operating room and the physician anesthesiologist are quoted separately at your consultation, because operating time varies a great deal from patient to patient, with your anatomy, your size and whether the donor areas sit next to each other; Dr. Cat sets the time after she has examined you, and the written quote itemizes every line. If the liposuction is already part of a body surgery you are planning with her, the fat for your face comes from that harvest and the $11,000 transfer fee is added to that quote.
The price reflects one surgeon who harvests, prepares and places the fat herself, one major surgery per surgical day, a physician anesthesiologist and an accredited facility. Please do not shop fat transfer on price: fat harvested roughly or placed in large deposits either disappears or lumps, and correcting it costs more than the operation done well. Our liposuction cost guide explains how the harvest is priced; our cost guides cover every procedure. Insurance does not cover it.
Consultation fee and financing
A consultation with Dr. Cat is $500, or $1,500 for a revision consultation, and the full amount is credited toward your surgery. To pay over time, the practice partners with Cherry, its primary financing partner, and also accepts CareCredit and Alphaeon Credit; see financing and payment plans.
Your consultation with Dr. Cat
It starts with a free 15-minute discovery call with our Patient Concierge, who books your consultation. Patients come to Dr. Cat for facial fat grafting from across Los Angeles and from out of town; at the consultation, in person on Rodeo Drive or, for out-of-town patients, by private video consultation through OnPatient, the HIPAA-secure patient portal, she does a detailed facial evaluation: where the volume has gone, whether the face has dropped as well as deflated, how the eyes, the forehead and the neck relate to the cheeks, and where the donor fat will come from. She takes a complete medical history, tells you plainly whether fat transfer, filler, an eyelid lift, or nothing yet is the right plan, and you leave with an itemized written quote.
