What about fat injections? They sound good!

My dermatologist recommends injecting fat over other dermal fillers. She says it is more natural, lasts longer and most cost effective since she does in-office liposuction to harvest it. I haven't found any mention of it on your site. What is your opinion of fat injections as compared to the other dermal fillers?

The reason I don’t recommend it more is because there are so many problems with it in the U.S. and in many other countries.  For example, since these are living cells, sometimes they don’t ‘take’ in the recipient site evenly which can create bumps which are hard/impossible to correct.  Sometimes the donor site gets lumpy from harvesting that wasn’t even. 

The longevity of it is unpredictable. In some people, it lasts nicely for years and in others, it’s gone in less than a year, for example.  Even more frustrating for patients, it doesn’t always wear off evenly so in one cheek the fat may persist longer than the other cheek.  I have a patient currently (from another office) where we have to even up the cheek with less fat volume with Restylane regularly or it looks odd. 

Bruising – if very small amounts are done at one time, the bruising usually isn’t too bad. If the fat is kept for future treatments, it generally is less healthy and doesn’t take as well.  If a lot is done at once, bruising can be significant and last 3 weeks with the swelling around it sometimes lasting 4-6 weeks (especially lips).

I would love to recommend it more but it’s far from a perfect solution.  Having said that though, the most experienced doctors with this can get very nice results.  The trick is finding those doctors. Also, good doctors really educate their patients well.  Be careful about dermatologists or plastic surgeons who minimize potential problems or gloss over them with this procedure.      Hope this helps,  Dr. I

Dr. Brandith Irwin, MD

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