Fat transfer to the face

Basic information

In facial fat transfer, the patient’s own fatty tissue is used as a filler on the face instead of external fillers.

Fat transfer to the face generally follows the same basic procedure. First, fat is removed from some part of the body. The fat is then purified and processed into a suitable form. Finally, the highest-quality portion of the harvested fat is transferred to the face.

Facial fat transfer can be performed either under local anaesthesia or general anaesthesia. Different forms of anaesthesia are discussed during a free consultation.

At Cityklinikka, fat transfers are performed by both an aesthetic physician and a plastic surgeon.

There are differences between fats

When talking about fat transfer, it is a very broad concept and phenomenon. The term “fat transfer” essentially only means that fat has been taken from one place and placed in another. Many patients have experience with previous fat transfer procedures. However, over recent years the technique has developed rapidly, and today the procedure can be performed in several different ways, for example using water-assisted methods.

Choosing the correct technique is very important for the final result. The fat to be transferred can be harvested in many different ways and using different sizes of suction cannulas. In facial fat transfer, three techniques and fat types can be used:

• “Traditional” fat, i.e. macrofat, behaves similarly to large-particle fillers. It can be used to enhance facial contours and add volume to facial features.
• Microfat can be used to correct wrinkles and fine lines.
• Nanofat is suitable for effective overall facial rejuvenation. The stem cells in nanofat provide long-lasting skin regeneration. The skin around the eyes becomes brighter, fine lines around the mouth are smoothed, and overall skin quality improves comprehensively.

Macrofat, microfat, nanofat

Fat transfer – indications for macrofat use:

• Correction of facial ageing changes
• Cheek augmentation (cheekbone enhancement)
• Jawline contouring

Indications for microfat use:

• Lip augmentation
• Filling wrinkles and fine lines
• Filling deep scars

Indications for nanofat use:

• Treatment of dark under-eye circles
• Rejuvenation and revitalisation of larger skin areas
• Horizontal forehead lines
• All superficial facial lines
• Neck tightening
• Treatment and firming of décolletage wrinkles
• Rejuvenation and firming of the skin on the backs of the hands

Nanofat transfer requires special expertise

Our clinic specializes in nanofat transfer. We were the first clinic in Finland to introduce nanofat transfer treatments. Nanofat transfer is always performed by a physician trained in the procedure.

The process of converting microfat into nanofat means that, through a specialised processing technique, the adipose tissue becomes liquefied and is rich in stem cells. The number of stem cells is a thousand times higher compared to the popular “vampire treatment,” in which PRP (platelet-rich plasma) is prepared from the patient’s own blood. The results are also more pronounced than with the so-called vampire treatment, while still remaining very natural.

Nanofat transfer improves skin quality and appearance in a long-lasting and significant way. Importantly, nanofat transfer has very few of the side effects associated with other fat transfer techniques, such as fat cysts or granulomas. The procedure is straightforward in the hands of an experienced physician or plastic surgeon.

About the procedure

Facial fat transfer does not require general anaesthesia, although it can also be performed under general anaesthesia. If the patient is not placed under anaesthesia, no special preoperative preparations are needed. Patients must always arrive for the procedure without makeup, jewellery, or piercings. Nail polish must also be removed (this applies to both fingernails and toenails).

Patients can usually go home almost immediately after a short observation period. Patients who undergo general anaesthesia are monitored for a few hours before discharge.

The areas where fat will be transferred are marked. After this, the required amount and type of fat graft are determined. Depending on the volume needed, fat may be harvested from several areas, such as the abdomen, flanks, or thighs. However, our principle is that only the amount of fat needed for the transfer is taken. If the patient wishes for more extensive fat removal, this must be discussed separately with the treating physician, as this would make the procedure significantly more extensive than a standard fat transfer.

Once the areas have been defined, the fat is harvested. The donor site can be almost any area where the patient has fat deposits. If the patient is not under general anaesthesia, the area is carefully numbed using a very thin cannula through a small skin opening before liposuction.

After the fat is collected, it is processed to obtain a graft of the appropriate quality and consistency. The processed fat is then placed into small syringes and injected into the target areas using very fine cannulas (i.e. blunt needles).

The procedure is quick, and preliminary results can be seen immediately. After the procedure, the transferred fat settles, and some of it is also naturally absorbed. To ensure sufficient volume, a slight overcorrection is performed, as part of the fat is reabsorbed within a few weeks. This helps avoid the need for another transfer in the near future and achieves a good aesthetic result. Sick leave is usually not required, but two to three days of recovery time is recommended.

Fat transfer can be performed using a water-assisted technique

WAL, or water-assisted liposuction, originates from Germany. Many people are familiar with the WAL method from liposuction procedures. The latest Body-Jet evo technique is also highly suitable for fat transfer procedures.

In water-assisted fat transfer, a thin, adjustable jet of pressurised water is used, enabling the precise and gentle harvesting of high-quality fat cells. The WAL method protects fat cells, blood vessels, and nerves from damage. This is particularly beneficial in fat transfer procedures, as it allows a larger number of intact, viable cells to be collected for transfer. According to studies, with the Body-Jet evo technique, up to 70% of the transferred fat may remain in the treatment area in the best cases.

Fat transfer or another procedure?

Facial fat transfer and filler treatment

Injectable fillers have an established role in aesthetic medicine. Injectable fillers containing hyaluronic have become increasingly common, and their safety profile is excellent when the treatment is performed by a qualified healthcare professional with sufficient training and experience in these procedures. From a safety perspective, it is also important that the products are obtained from a reliable manufacturer with long-standing experience in the field. The advantages of fillers are the simplicity and speed of the procedure, as well as immediate results. The procedure involves very few risks.

However, the drawbacks include the cost of fillers and the duration of the results. Fillers are typically packaged in prefilled syringes of 1.0–1.25 millilitres. The price per millilitre can be several hundred euros. A single millilitre is a very small amount and is not sufficient to treat many areas. As a result, treatment may be unsuccessful or the outcome incomplete due to insufficient filler volume. The results of filler treatments typically last 3–9 months. If the effect is to be maintained, the treatment must usually be repeated once or twice a year.

The main advantage of fat transfer is that there is usually an ample supply of fat available. In most cases, all problem areas can be treated in a single session. In facial fat transfer, several tens of millilitres of fat are commonly used. Injecting such volumes with fillers would be impossible. The transferred fat settles within a few weeks, and its durability is very long-lasting, usually several years. Of course, weight loss and significant fluctuations in body weight can affect fat retention.

If there are many areas in the face that require correction and volume restoration, fat transfer is a better option than using fillers.

Fat transfer and other anti-ageing treatments

Fat transfer does not replace a traditional facelift. Fat transfer restores lost facial volume, while a facelift removes excess skin and corrects laxity caused by ageing. The procedures complement each other. In many cases, a traditional facelift can be avoided or postponed when facial appearance is rejuvenated with fat transfer.

Botox treatments do not directly compete with fat transfer. They target the facial expression muscles, relaxing them and reducing wrinkles. However, nanofat can also effectively soften wrinkles in common Botox treatment areas such as the forehead and around the eyes. It can also treat under-eye wrinkles, where Botox is not effective.

Compared to laser treatments, fat transfer is more effective in revitalising severely aged skin. Laser treatments stimulate the skin’s own collagen production. However, in significantly aged skin, collagen production is very low. In patients over 60 years of age, stimulating collagen production is extremely difficult, even impossible. Nanofat, which contains a high concentration of stem cells, stimulates collagen production regardless of age and treatment area. It is a superior method for improving skin quality and is also suitable for older patients.

Laser and chemical peels work best on the superficial layers of the skin. Recovery from these procedures can be lengthy, especially when strong lasers or potent acids are used. Recovery from fat transfer is often somewhat faster than from deep chemical or laser resurfacing treatments.