Volume loss in the face is a natural result of aging — so it seems only right that we would use an all-natural approach to correct our facial hollows and indentations. Fat transfer to the face is an increasingly popular, minimal-downtime method of filling, volumizing, lifting, and contouring areas of the face using fat derived from your own body. Board certified-dermatologist and facial sculpting specialist Dr. Jason Emer uses autologous fat grafting to plump areas of the face that require additional volume, improve facial structure, and make subtle enhancements in shape and contour.
During a Hi-Definition Liposculpture procedure (or through simple tumescent harvesting), excess fat is removed from your body; the fat is then processed and enriched before it is injected into the desired areas. In the hands of a meticulous facial sculptor like Dr. Jason Emer, the repurposed fat can be injected into your lips for a softer, plumper pout; into the cheek bones to achieve a modelesque, contoured look; into the temples to lift and volumize; into the chin for a subtle projection; and even into the ear lobes to improve the sagging, thinning, and wrinkling caused by earrings and aging.
Autologous facial fat grafting (using fat from your own body) can be employed independently or as a complement to fillers, Sculptra (an injectable collagen stimulator), and Renuva synthetic fat grafting to produce noticeable, immediate and long-term results. Fat transfers can improve hollows, deep lines and wrinkles, sagging, irregularities, and volume loss in all areas of the face, including the cheekbones, lips, chin, temples, and earlobes. Fat grafting is also commonly used to address acne scarring, facial trauma, or botched procedures. Regardless of your specific goals, Dr. Emer provides natural-looking, long-term enhancements to create a more harmonious facial structure.
How is the fat extracted?
Nearly everyone has some excess fat (often found in stubborn problem areas, such as the abdomen, flanks, thighs, or buttocks) that cannot be resolved through diet and exercise. It’s these problem areas that Dr. Emer will target when seeking out unwanted fat to be repurposed in the face and other parts of the body.
The pioneer of an advanced form of liposuction called Hi-Definition Liposculpture — which not only removes unwanted fat but also tightens the skin, improves cellulite, defines and contours the body, and corrects botched surgeries and irregularities — Dr. Jason Emer uses a state-of-the-art, water-assisted Body-Jet fat removal system to masterfully detach fat cells from connective tissue and separate tissue from the muscles to reduce bruising and swelling. The Body-Jet system is unique in that it allows Dr. Emer to control precisely how much fluid is used at any given time during a body contouring procedure. Additionally, Body-Jet’s tumescent fluid is highly pressurized to lift tissue and constrict blood vessels, ensuring safe fat removal with less fluid used, sparing of lymphatic tissue and vessels, and limiting downtime for tumescent liposuction procedures.
Dr. Emer then uses VASERlipo to disrupt and dislodge clusters of intact fat cells and provide simultaneous definition and sculpting enhancements. VASERlipo is an ultrasound-based system that uses ultrasonic cavitation to deliver acoustic energy beneath the skin, which creates stem heat under the skin’s surface, prompts skin tightening, provides definition and sculpting enhancements, and helps improve and soften scar tissue and irregularities from previous procedures.
Lastly, either by hand or through power-assisted devices, Dr. Emer is able to remove unwanted fat, which is then purified and harvested so that it can be reused to sculpt, define, and volumize targeted areas.
While many practices still utilize SmartLipo or other laser-based liposuction devices, these techniques are antiquated or “old school” and are not as effective in the disruption and removal of viable, sustainable fat cells. Laser-based liposuction permanently damages fat cells, and damaged fat cells cannot be used for harvesting, grafting, or contouring.
What happens after the fat is extracted from the body?
In the past, the extracted fat was washed, placed into centrifuge, and then re-injected back into the body. However, when using this technique, it was discovered that a significant amount would not survive; the injected fat would simply disappear.
Dr. Emer now uses Puregraft microfiltration, a top-of-the-line purification method that selectively and gently filters out contaminants and impurities — such as blood, toxins, debris, lipid (or oil), fluid, connective tissue, and fragmented cells — to arrive at the purest, most viable fat for injection and vastly improve fat retention. Puregraft was developed by the world’s foremost experts in adipose science in order to improve inconsistency and unpredictability in fat grafting. According to a 2014 fat grafting survey, Puregraft is “the only system proven to consistently remove 97% of excess components and significantly improve long-term retention.” The end result is a concentration of the cleanest, healthiest, most viable fat.
Once it has been processed, the fat solution is then infused with stem cells (such as ACell) and growth factors such as platelet-rich plasma (or PRP), a high concentration of protein derived from the blood that helps maintain a fresh, youthful appearance and has countless benefits, including improvements in acne, wrinkles, cellulite, and sun damage. Enriching the concentrated fat solution with growth factors gives the fat improved longevity and viability. Moreover, the rejuvenating properties of the stem cells create improvements in skin texture, color, and tone in the treatment area.
In addition to ACell, Dr. Emer also enriches the fat solution with exosomes, a new, 100% natural stem cell product that helps improve fat viability and longevity.
Once the fat has been purified and enriched, the fat can be used throughout the body to lift, shape, add volume and definition, provide additional contour, and/or fill and camouflage indentations and irregularities from previous botched procedures. The fat is like a graft: Once it is injected into the body, the body creates blood vessels around it, and then it stays there permanently.
The purified fat can even be filtered down to a specialized “nanofat” to treat thinner skin; to improve dimples and wrinkles in the face, neck, and chest; and to address smaller areas of the body, including the eyelids, eyebrows, and forehead.
What happens to any unused fat?
Fat and stem cells that are not used in fat grafting can be harvested and stored to further build on the already improved outcome or for future use as needed. Likewise, any unused stem cells can be stored in a stem cell bank and preserved for future use to combat age-related diseases with advanced therapies.
How is the fat injected?
Once Dr. Emer has mapped out the procedure and decided which areas would benefit most from fat grafting, he artfully injects the purified fat in small amounts in different layers of the muscle and tissue; with this method, the tissue is enhanced and builds volume over time. The fat is injected via a blunt-tipped cannula, which reduces complications (such as bruising, swelling, or pain) that one would typically experience with a sharp needle.
Fat transfer procedures must be performed by an experienced provider and expert in fat grafting. Any errors or improper injections could dramatically alter a patient’s appearance, and these treatments are both difficult and costly to reverse (if able to reverse at all). Board-certified dermatologist and fat grafting expert Dr. Jason Emer has spent years honing his techniques and perfecting the fat extraction technique and harvesting methods, minimizing any risks or complications associated with the procedure and ensuring natural, subtle improvements.
Improving Volume Loss with Facial Fat Transfer
Certain areas of our face are prone to natural volume loss as we age, including the eyebrows, temples, cheeks, under-eyes, and jawline/chin, all of which can give your face a thin, gaunt, and unhealthy appearance with aging. For patients with severe facial volume loss, facial trauma, or botched procedures, Dr. Emer often uses fat grafting to make significant improvements in depressed, hollow, or sunken areas of the face. When complemented with Sculptra (a natural collagen stimulator) and platelet-rich plasma (PRP), facial fat transfer can revolumize the area and also provide sculpting and contouring to improve facial symmetry and balance. While dermal fillers are merely a temporary solution for volume loss improvement, fat grafting offers permanent revolumization; adding Sculptra and PRP can help to further improve the outcome and increase viability and longevity.
Improving Hollows Under the Eyes with Facial Fat Transfer
Under-eye hollows, dark circles, and deep tear troughs are all early signs of aging that make us look more tired and less rested. Both facial fat grafting and dermal fillers (such as Juvederm Volbella/Vollure, Restylane Defyne/Refyne, Belotero, and Restylane Silk) can be used in layers to plump the trough that surrounds the skeletal orbit and lift the cheek fat pads (with Juvederm Voluma, Radiesse, and/or Restylane Defyne/Refyne) that support the under-eye. Precision injecting in a layered fashion from a skilled facial sculptor like Dr. Emer is essential to achieve natural, subtle outcomes.
Cheek Augmentation with Facial Fat Transfer
While dermal fillers (including Voluma, Vollure, Radiesse, Restylane Defyne, and Bellafill) are typically used in Cheek Augmentation procedures to restore shape, contour, and volume to the midface. Dr. Emer can also create dramatic, immediate and long-term improvements with facial fat grafting. Injecting into the deep fat pads of the cheeks, Dr. Emer can plump and elevate the midface as well as improve dark circles and hollows under the eye. For patients looking to enhance their cheeks who do not respond well to fillers, a cheek augmentation with fat transfer offers permanent volumization with minimal downtime.
Similarly, for patients with a recessed chin, Dr. Emer uses a combination of fat grafting, dermal fillers (Radiesse, Restylane Defyne, Bellafill, and Voluma), Sculptra injections, and surgical implants (if necessary) to project and build volume in the chin area.
Lip Augmentation with Facial Fat Transfer
While lip fillers like Juvederm Voluma, Juvederm Ultra Plus, Juvederm Vollure/Volbella, and Restylane Defyne/Refyne are popular choices to plump and volumize the lips, patients looking for a “permanent plump” can achieve long-lasting improvement in contour and size with a fat transfer to the lips. For lip augmentation with fat grafting, Dr. Emer uses a microcannula injection technique, moving slowly and meticulously and measuring every drop of fat injected into the upper and lower lips. The fat creates immediate improvement in fullness and shape, and the microcannula limits the amount of bruising, swelling, and pain. The results of this treatment are permanent, providing long-term, natural-looking volumization.
Ear Rejuvenation with Facial Fat Transfer
As we age, the soft tissue in our earlobes gradually thins, leading to visible wrinkles and creases as well as volume depletion and elongation. Add to that the fact that we subject our ears to constant sun exposure and cumbersome earrings, and it’s no surprise that our ears sag and stretch over time. Dr. Emer injects both purified fat and dermal fillers like Radiesse or Juvederm Voluma/Vollure to achieve instant plumping, to repair and minimize earring holes, and to fill the wrinkles, creases, and fine lines that develop with age.
Although Ear Rejuvenation with fat grafting is a quick and painless procedure, it must be performed by a fat grafting expert to ensure that the fat is properly injected and that the ears are not overfilled.
Improving Atrophic Acne Scars with Facial Fat Transfer
Atrophic (or depressed, crater-like) acne scars often require a combination approach using fat grafting; Bellafill, a semi-permanent injectable filler made from polymethyl methacrylate (PMMA) microspheres; and subcision, in which a blunt-tipped cannula or specialized sharp needle (Nokor) is inserted beneath the skin to release tethered acne scars that are bound to the subcutaneous tissue. Dr. Emer then injects purified fat or fillers like Bellafill, Radiesse, Sculptra, Restylane, Belotero, or Juvederm to plump the previously tethered area, prevent further indentation, and (in some cases) gradually build collagen. Over time, the fat cells fill the space beneath the scars, smoothing their appearance long-term.
What is synthetic fat grafting?
For those who are too lean or athletic — or for those who are apprehensive about a Hi-Definition Liposuction or fat harvesting procedure — Renuva is an allograft (i.e. a tissue graft from a donor) adipose matrix specifically designed to treat small-volume aesthetic irregularities. The product is derived from cadavers’ fat cells, which are meticulously tested, screened, and purified. The fat cells are also hydrated in fluid to ensure smooth administration to the desired treatment areas.
Once injected, Renuva forms a matrix or supportive framework beneath the skin and recruits your existing surrounding fat cells to repopulate and build volume in the area. The result is a gradual plumping effect, enhanced long-term collagen production, and improved skin texture and tone over the course of 3 to 6 months. After a short period of time, Dr. Emer can determine if additional treatments would be beneficial to further improve the results. Numerous small volume treatments are often needed for improvement.
When injected properly, both synthetic fat grafting and autologous fat transfers offer permanent improvement in skin tone, texture, volume, and contouring. A series of treatments are often needed to adequately produce the desired textural and volume enhancements. Dr. Emer recommends that his patients schedule Renuva treatments every 6 to 12 weeks until optimal improvement is achieved.
What other treatments can be combined with facial fat grafting?
For non-surgical facial sculpting and contouring, Dr. Emer combines facial fat grafting with strategically placed fillers (such as Voluma, Radiesse, and Bellafill), silicone (Silikon 1000) injections (especially for patients with HIV / lipoatrophy), Sculptra, and Renuva synthetic fat grafting to correct volume loss; fill indentations; improve under eye hollows and dark circles; augment the cheeks, temples, and lips; sculpt and define the jawline and chin; and improve overall facial balance.
Fat grafting to the face and/or body can easily complement other procedures, including surgical facelifts and energy-based treatments like lasers and microneedling with radiofrequency.
How long do improvements last?
Permanent results can be seen 6 to 12 weeks after treatment. To maintain the outcome, Dr. Emer recommends regular injections of Sculptra, PRP, and stem cells / exosome therapy. Additional fat grafting or injectable fillers can further improve the outcome as desired.
While fat grafting results are permanent, not all fat will survive. Dr. Emer’s advanced water-assisted Body-Jet harvesting and purification methods vastly improve the longevity of the treatment by extracting and transferring only the most viable and most sustainable fat cells to the body.
Is it painful?
Dr. Emer uses topical numbing and nerve blocks to minimize the pain and discomfort experienced during the procedure. Oral or injectable medications can also be used if needed.
What is the downtime?
Downtime after a fat grafting procedure is often minimal, but the precise amount of downtime and swelling depends on the area treated, the extent of the Hi-Definition Liposculpture procedure, and the amount of fat extracted from and re-injected into the body. Following a formal evaluation and development of a personalized treatment plan, Dr. Emer can provide you with a timeline for your procedure, including the duration of the procedure itself and the amount of downtime you can expect.
On average, patients tend to return to work after 3 or 4 days. The swelling subsides after a few weeks, and the final result can be seen within a few months.
Am I a good candidate?
Ideal candidates for facial fat transfer procedures are individuals seeking a permanent solution to volume loss or long-term enhancement or augmentation to their facial features. Additionally, patients must have excess fat available for extraction and be willing to endure a Hi-Definition Liposculpture procedure (or, at the very least, a simple harvesting procedure); individuals who do not meet that criterion can substitute autologous fat grafting for a Renuva synthetic fat grafting procedure.
To determine if you are a good candidate for facial fat transfer, schedule a formal evaluation with board-certified dermatologist and fat grafting expert Dr. Jason Emer.
How do I schedule a consultation with Dr. Emer?
To schedule a consultation with Dr. Emer in Beverly Hills / Los Angeles / West Hollywood, California, please reach out to our concierge to schedule an appointment. Call 424-800-4140 or email us at [email protected].