Facial Fat Grafting Versus Injectable Fillers - Important Factors to Consider
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- Опубликовано: 19 ноя 2020
- More on facial fat grafting/transferring: prasadcosmeticsurgery.com/med...
For more on facial fillers and Structural Volumizing, please go to: prasadcosmeticsurgery.com/y-l...
For more about Dr. Prasad's background and training, please go to:
prasadcosmeticsurgery.com/dr-...
New York facial cosmetic surgeon Amiya Prasad, MD reviews the different procedures for facial volume enhancement, the significant issues of fat grafting/fat transferring, possible risks of facial implants, and how Dr. Prasad uses specialized techniques to restore volume at the bone structure level using safe and predictable cosmetic fillers:
0:20 - Introduction to fat grafting, and fillers
1:01 - Dr. Prasad's credentials in cosmetic and reconstructive surgery, and oculofacial plastic surgery
1:15 - How collagen injections Zyderm® and Zyplast® were the first fillers
1:42 - How fat grafting was the popular treatment choice for facial volume enhancement prior to 2005
1:58 - How fat grafting is done
2:22 - The significant issues of fat grafting
3:08 - How fat grafting usually requires a second procedure
3:31 - How transferring fat does not address the more significant bone loss
4:17 - What facial implants are
4:40 - The risks of facial implants
5:03 - What hyaluronic acid fillers are
5:24 - How hyaluronic acid fillers are reversible with the enzyme hyaluronidase
5:52 - How thicker hyaluronic acid fillers are placed at the bone level
6:06 - How superficially placed fillers tend to migrate
6:42 - How Dr. Prasad uses specialized techniques to restore volume at the bone structure level
7:52 - What Structural Volumizing is
8:24 - Fat grafting drawbacks
8:54 - Conclusion and Dr. Prasad’s recommendation
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Wow this is the most clearly explained video on this topic I have ever seen!!! Thank you SO much for this.
You're welcome, Louise Corrans! I'm really happy you found the video clear and helpful!
Yes! I found this video very helpful Doctor! Thank you for educating us!
You're welcome, nasty badger! I'm glad you found the video helpful!
Hi Amiya thank you for another great video.
I've had two fat transfers (one in 2005 and then in 2011) to the face and both had poor results. Both were costly (in comparison to synthetic fillers) and required anesthetic.
The first one made no visible difference after 3 months, the second one resulted in lumpiness.
I've since had Juvaderm Voluma which was significantly effective, cheaper and required no anesthetic!
I agree that it's one thing to have access to fillers and quite another to have the skills to use them effectively - which you clearly can!!
Hi spottydog4477,
I'm happy you liked the video, but it seems it would have helped you more if it was made sooner! And thank you for your compliment!
Your videos r really too much helpful in clearing the doubts....
I'm glad the videos help you, Promila Sharma. Thank you for watching!
Thank you so much for this detail information........😊
You're welcome, Venus Z! Glad you found the video informative!
Very informative video..tq .. i watch your videos for the beautiful smile you have😊👌
You're welcome, Rashmi Manjunath! Thank you so much for the kind compliment, and for watching my channel! I'm happy you find the videos helpful and informative!
The video was incredible informative and very helpful. I had fillers about four months ago and they look incredible. Then while browsing my RUclips account a few weeks ago PDO thread and fat grafting popped into my recommendation list. After looking at PDO thread videos and reading the comments I decided it was not for me. There were many reasons but one of the main one was from a woman in the comments who mentioned that six months of having done the threads snapped when she sneezed which then torn a lot of her cheeks. This left me with fat grafting and I wondered if I made a mistake picking dermal fillers instead of saving my money and going for fat grafting. After watching your video I am glad I did not go for that option.
I'm glad you found the video helpful, and it helped reinforce decision, oliver queen!
@@AmiyaPrasadMD
Thanks
You're welcome,@@oliverqueen2078 !
The only Plastic surgeon on youtube that actually answers questions from the viewers. Amazing. Dr. Prasad, do you think people with autoimmune conditions, like Hashimotos or Sjogren's might metabolize the filler faster? Does a filler placed deeper at the bone level last longer than one placed more superficially, because of muscle movement at the top?
Hi AR H,
Thanks for the appreciation! I perform filler treatment on patients with autoimmune conditions, and I have not seen evidence of rapid metabolization with these patients. Filler at the bone level can last a little longer as there is not as much activity at this level than if placed closer to the skin. I hope this clarifies things for you.
Thank you so much! #Keepsafe
You're welcome, Maricar L. Bergomio! I'm glad you found the video helpful! Thanks again for watching!
Thank you for explaining this. I LOVE your videos! :-)
You're welcome, Val O! I'm glad you found it helpful. Thank you for watching!
Thank you!!!!
You're welcome, Victoria Rydzyk. I'm glad you found the video informative.
Wow live here in So Cal. Really love your science based approach with diagrams. Grew up back there now I wish I could afford traveling for Y lift. I assume it has to been done annually ie the life of the filler?
Hi Diane Greer,
The longevity does depend on the thickness of filler used, and your metabolic rate. Juvederm Voluma does last about two years, depending on the individual patient. I hope this clarifies things for you.
Dr. Prasad: Thank you for for your video. I would like your opinion regarding the crotin oil/phenol acid peel to improve fine lines, skin discoloration, and tightening of the skin. Would you recommend this type of peel? Are the risks very high? A local board certified plastic surgeon, who was referred to me, recommended this for the best Improvement for my face. Thank you very much.
Hi Mary Minore,
As your doctor has examined your issues you want treated, and your skin, it's not my place to contradict their recommendation as I have not examined your skin, so I would need to perform a physical exam to give you a proper second opinion. I hope this helps you.
OMG you’re a genius! I strive to be such an intelligent doctor like you one day 🙌🏼🙌🏼🙌🏼 lol 😃
Thank you for the compliment, Mariann Garza! I hope your medical practice does well!
Does fat transfer spread eventually like filler leaving you with a fuffy face?
Is fat filler permanent filling or do we have to keep up with maintenance like derma filling
Hi Bianca Dort,
While facial fat transfers are less predictable than filler because of how much fat is reabsorbed by the body, the puffy face result from either procedure is more of a result of the doctor's technique rather than the material. As you can see in the video, my patients for filler and fat transfer don't appear puffy.
Fat does last longer than filler, once the fat takes and settles. As explained in the video, 30-70% of grafted fat is reabsorbed by the body soon after the surgery, so expect at least one additional surgery soon after the first to compensate for fat absorption. I hope this clarifies things for you.
Do you think a combination of PRP and filler under the eyes is effective for hollowness and fine lines? I’m 22 but my under eyes have always been an issue
Hi Nadia Moustafa,
That's a possible treatment combination, and likely a good one for your age as the lines shouldn't be significant. You can refer to these videos on how I usually treat hollowness, and wrinkles under the eyes:
ruclips.net/video/VzzsbNDlaHQ/видео.html
ruclips.net/video/PXMhY90TReM/видео.html
Thanks for your videos, they are really informative! I have been wanting fillers but afraid of swollen face, my hubby who is OMFS is really against them for that reason 😭. Does everyone put them in at bone level now? Too bad you are not in Maryland!
Hi siddrah chaudry,
Very few doctors do place filler at the bone level, which does avoid that swollen look. You can look up doctors who perform the Y Lift, which is bone level placement, but the aesthetic styles of doctors who perform it do vary, so it's important for you to find a style you like. Also, we do have an office in Vienna, Virginia, if you are interested in waiting for an appointment there (I'm not there as often as I'm in New York). I hope this helps you.
@@AmiyaPrasadMD Yes I can come to Vienna! I will try look it up! Thank you!
You're welcome, @@sid8132! Hope to see you soon!
This video is 2 years old. Is your opinion the same in regard to fat grafting
Hi @lisaaustin4561,
Yes, grafted fat still needs to take to a new blood supply to remain viable, so results are still unpredictable. Hyaluronic acid fillers do not require a blood supply to be viable, so results are more predictable, and customizable. I hope this clarifies things for you.
@@AmiyaPrasadMD thank you! Wish I lived near you I’d have you do my fillers
You're welcome,@@lisaaustin4561
Generally, would fat injections help heal any inflammation and damage associated with laser damage?
Hi Sarah Tummon,
It's not that simple to transfer or inject fat as grafted fat requires a new blood supply to be viable, as detailed in the video. I hope this clarifies things for you
Can you remove fibrosis under eye? Would RF help? Also will it eventually disappear on its own?
Hi Kristine Hoffman,
Sorry to hear about your problem. I hope you understand that I would have to examine your eyes first before making a specific recommendation for treatment. I hope this helps you.
Hylauronic acid and sodium hylauronate are fully same in moisturizers??
Hi Val sala,
Ingredients as well as concentrations of ingredients of moisturizers do vary greatly. It's important to get moisturizer from a reliable and reputable source. I hope this clarifies things for you.
Dr....I don't have dark circles,....Is it possible to prevent dark circles,bags by leading a very healthy lifestyle,care and also using hylauronic acid moisturizer under eyes??
Hi Val sala,
It is possible to prevent dark circles that are due to health and environmental factors like smoking, pollution, sun exposure, etc., but eye bags are not caused by health or environmental issues. Also, there are other causes of dark circles that are not caused by health or environmental issues, like pooled blood, thinned skin, genetics, and pigment. I hope this clarifies things for you.
Dr,...vit c serum which is used on face can be applied on lips??..……any problems??
Hi Anjali Mohan,
There are many vitamin C topical formulations, so I would have to know which one before recommending it for the lips. I hope this helps you.
Dr.....telogen effolivium and genetic hair loss always happens together?
Hi Val sala,
No, they do not always occur together. They can occur separately, or together. I hope this clarifies things for you.
Hello doctor, can unsaturated fat such canola oil or olive oil used for face filler ?
Hi hermiya tan,
That is absolutely not safe, or effective. Even if edible oil could be safely injected (they can't), they would not hold any shape, or be prevented from metabolization to be used as a filler. I hope this clarifies things for you.
But are these fillers ans to everything...like can they restore the damage caused by excess skin removal
Hi @shraddha5963,
Fillers are for address volume loss due to aging, or a genetic volume deficiency. For excess skin removal due to eyelid surgery, you may need reconstructive surgery, with possible grafting procedures. You can refer to these videos about it:
ruclips.net/video/hAmOWx0ZY04/видео.html
ruclips.net/video/wT9mSBvAlno/видео.html
Dr....if there is nutrition deficiency,then only there is need to take nutrition tablets for hair loss?
Hi Anjali Mohan,
Genetic pattern hair loss is caused by genetics, not by nutrition. However, vitamin deficiency like vitamin D can impact hair health, but vitamin D deficiencies are easily solved as it can absorbed by the skin through sunlight. I hope this clarifies things for you.
Dr, doing microdermbasion , chemical peels is fully safe if its done by an experienced doc,....right!
Hi Anjali Mohan,
There is no medical procedure that is completely devoid of risk, but experienced doctors to minimize risks. I hope this clarifies things for you.
Doc,....a continued stress of total one week can cause hair fall??
Hi Anjali Mohan,
It is possible, but stress-related hair shedding is temporary, if there are no other causes of hair loss. I hope this clarifies things for you.
How much (approximately) does this facial grafting cost?
Hi Lea Ann Abbey,
We don’t have set costs for surgery or treatment as each patient has different needs, and some surgeries or treatments are more extensive than others. You can contact our offices or our websites for a price range. Our offices are located in Manhattan, New York City which you can call at (212) 265-8877; Garden City, Long Island at (516) 742-4636; or Vienna, Virginia at (703) 356-1336. You can also reach us through www.prasadcosmeticsurgery.com, www.eyelifts.com, or www.puffyeyes.com by filling out a contact form, and we will get back to you regarding price range. I hope to hear from you soon.
Retinol can be used without consulting a doc?
Hi Anjali Mohan,
Retinol is usually only present in prescription strength skincare products, so you do have to see a doctor. I hope this clarifies things for you.
Frget about the info dude.... The way he speaks❤❤❤❤❤ i fel for him
Thank you for your kind words, madeeha khan. I'm flattered :)
Dr...if there is one day stress,....then there will be hair fall?
Hi Anjali Mohan,
Stress would need to be severe and somewhat prolonged to induce hair shedding, so one day stress is highly unlikely to cause hair shedding. I hope this clarifies things for you.
Doc does filler make face damage or if you stop doing filler it's damage our skin pl reply
Hi Shruti Jadhav,
Fillers are placed under the skin, not directly into the skin. If you are worried about stretching the skin with filler, it doesn't happen, and I made video about it, for your reference - ruclips.net/video/hx540qDFbrs/видео.html
Can fat transfer be used for rolling acne scars??
Hi Oliver Queen,
Facial fat transfers for acne scars are still subject to the same unpredictability of grafted fat, which needs a blood supply to take, and doesn't hold a consistent shape once removed from its original blood supply. For acne scars due to tissue loss, I would still use fillers, combined with other modalities, as fillers do hold a shape, and don't need a blood supply to be viable. I hope this clarifies things for you.
Dr i just had fat lip fillers on my lips, its been a week now and my lips are soo swollen. I look ridiculous. Please educate me and reassure me. The doctor said i need 2 more weeks and the swelling go away. I asked for natural lip fullness couldn't believe this is happening to me .
Hi Ray Ray,
Sorry to hear about your problem. Do you mean you had fat injected into your lips? I don't recommend or perform fat grafting to the lips as it's not predictable procedure. It is still early after your procedure, so I suggest you follow your doctor's advice as I have not seen your situation, and I don't inject fat into the lips. I hope this helps you.
Do you offer undereyelid fat grafting?
Hi Cat,
I strongly advocate against fat grafting under thin eyelid skin because it is highly prone to complications. I've made several videos about it, for your reference:
ruclips.net/video/mNo_EBcDi1k/видео.html
ruclips.net/video/VzzsbNDlaHQ/видео.html
ruclips.net/video/TF7MBrszslc/видео.html
What do you think fat transfer to the breasts?
Hi yayadrew,
Once fat is removed from its original blood supply, it does not hold a consistent shape, and needs to take to a new blood supply, so there are risks that prevent me from doing this for my patients. I don't perform fat transfers to the breast area, but you can consult with a doctor who has more experience with this procedure. I hope this helps you.
Can this be combined with a facelift to achieve the lifting effect and removing of skin laxity. This way you would also reposition the fascia to a more youthful position
Hi @dencentbeatz794,
Yes, volume enhancement is often done with a facelift as facelifts don't treat volume loss for the long-term. Facelifts may initially appear as treating volume loss, as post-surgical swelling does create an appearance of volume, but this doesn't last past the initial healing period. Facelifts were often done with facial implant surgery in the past. Filler is more of an alternative to facial implants, as fat grafting can't be done at the foundational bone level. I hope this clarifies things for you.
@@AmiyaPrasadMD I see, is this something you perform with your facelifts? Adding deep dermal filler to the bone? My only Inquiry is, what should be done to avoid filler fatigue. A lot of facelift surgeons and plastic surgeons say that you shouldn’t use filler long term as it could lead to overfilling the face. Since filler doesn’t fully go away after the time period it is meant to last for, do you add less and less filler each time?
Hi@@dencentbeatz794,
For maintenance after the initial treatment, less filler material may be used. The appearance of an overfilled face is due to more superficial placement of filler, which often leads to filler migration. Filler migration is prevented in bone level placement as the overlying muscle layer holds the filler in place better than skin, fat, and soft tissue. I hope this clarifies things for you.
@@AmiyaPrasadMD yes it does thank you. Do you usually perform facial volume replacement with this type of filler placement technique with your facelifts?
Hi@@dencentbeatz794,
Yes, I perform this technique of volume enhancement with a facelift because a facelift by itself doesn't treat age-related volume loss. I hope this clarifies things for you.
Hello Dr! Can the lumps occur if the fat that is being used is "micro fat"?
Hi Pamela Fernandez,
Grafted fat, no matter the way it's branded, still needs a new blood supply to be viable, and still has an inconsistent and unpredictable texture once removed from its original blood supply. I hope this clarifies things for you.
@@AmiyaPrasadMD thank you! Definitely well understood.
You're welcome, @@Alinathebom!
Hello doctor
What are the chances of fat embolism after fat transfer to chin and hollow cheeks? How can it be avoided?
Hi curtana,
There is a risk of fat embolism with any fat grafting/fat transfer procedure, so it can't be completely avoided. Risks of an embolism can be reduced by the experience of the surgeon, but it's always a risk. I hope this clarifies things for you.
@@AmiyaPrasadMD I want to get fat transfer to my sagging lower face with scars and to my chin. Does cannula eliminate this risk ?
Hi@@cortana9553,
No, cannulas may reduce the risk of piercing an artery, but they don't eliminate the risk of an embolism. I hope this clarifies things for you.
How long last fat injection
Hi dinesh ghaywat,
30-70% of grafted fat is absorbed by the body soon after the procedure, while remaining grafted fat can last several years. I hope this clarifies things for you.
What about using Belafill for that Y Lift you described? I've had fillers 3x using that same technique, but within 5 months the fillers wore off... even though they were supposed to last one to two years. I tried three times and each time the effect wore off after 5 months. I loved how it looked, but hated having to redo it so often. Can it be done with a longer-lasting filler like Belafill?
Hi missmgmnt,
Have you tried using Juvederm Voluma, which is the thickest and longest hyaluronic acid filler? Bellafil uses PMMA (polymethylmethacrylate) which is not safely metabolized by the body, so I don't use it as it can cause potential complications. You can refer to this video about why I don't recommend or administer semi-permanent and permanent fillers - ruclips.net/video/CZJ05rjav3s/видео.html
Hello doctor.. After my day 70 ... I was involved in a fight.. Not the hand shake just fight with mouth... Tat time I got very much tensioned. And pressureed and stressed .it was a big fight. After tat i got little bit shevered and my body heated um..an body stared little bit shaked.nd after some time iam ok... But not an hand shake just with mouth.It will affect any thing. Of my result sir.. Iam very much worried sir..
Hi mohammed 432,
Sorry to hear about your problem. It's not clear what procedure you had, but you can see your doctor who performed the procedure for a follow up. I hope you understand that I can't assess any potential damage from just your description, so a physical examination is needed to determine if anything has been affected. I hope this helps you.
@@AmiyaPrasadMD fue doctor
Hi@@gowtham6426,
70 days after your transplant is already pretty long, and your grafts are secure. If there was no damage to your scalp, you shouldn't have anything to worry about, but you can still follow up with your surgeon if you are worried. I hope this helps you.
How much fat grafting for face
Hi Abdullah Khan,
Assuming this is the right procedure for you, we don’t have set costs for surgery as each patient has different needs, and some surgeries are more extensive than others. You can contact our offices or our websites for a price range.
Our offices are located in Manhattan, New York City which you can call at (212) 265-8877; Garden City, Long Island at (516) 742-4636; or Vienna, Virginia at (703) 356-1336. You can also reach us through www.prasadcosmeticsurgery.com, www.puffyeyes.com, or www.eyelifts.com by filling out a contact form, and we will get back to you. I hope to hear from you soon.
After a common cold,....hair fall can occur?
Hi Val sala,
There is no link between the common cold and hair loss. I hope this clarifies things for you.
There is a youtuber Dr. Amir Karam who swears by fat transfer to the face and chooses it over filler almost every time. He swears his results are consistent, long lasting and don't require revision surgery. Is her lying? Is it all in some proprietary technique? If he had as many revisions or unhappy customers as you mention, wouldn't he stop doing it? Thank you.
Hi AR H,
Facial fat transfer does require two surgeries initially: one to harvest the fat, and one to place the fat. Since 30-70% of grafted fat is quickly absorbed by the body, both procedures usually need to be performed again soon after the initial procedures. I do prefer to place filler non-surgically, as it's more accurate, precise, and predictable. I hope this clarifies things for you.
Where are you located dr
Hi Maryamruun Maxamud,
Our offices are located in Manhattan, New York City which you can call at (212) 265-8877; Garden City, Long Island at (516) 742-4636; or Vienna, Virginia at (703) 356-1336. You can also reach us through www.prasadcosmeticsurgery.com, www.eyelifts.com, or www.puffyeyes.com by filling out a contact form, and we will get back to you. I hope to hear from you soon.
Ok thanks dr amiya how much cost for fat transfer to face
And what is the long last
Hi @@maryamruunmaxamud4514,
We don’t have set costs for treatment as each patient has different needs, and some treatments are more extensive than others. You can contact our offices or our websites for a price range. Fat grafting does last longer than filler treatment, but facial fat transfers are not as predictable as filler treatment, as shown in the video. I hope this clarifies things for you.
? For you I did fat grafting over 2 years ago to cheeks and feel like I have too much. It isn’t settled and I want to dissolve or get some out what are your suggestions??
Hi Dragon Fly19,
Sorry to hear about your problem, but grafted fat can't be safely dissolved. Grafted fat will require surgical removal. I can only give a proper second opinion and suggestions for specific treatments after a physical examination of your face. I hope this clarifies things for you.
@@AmiyaPrasadMD I understand what are the chances of nerve damage? My surgeon said no one asks for removal so I don’t think he has experience in this area
Suddenly I got sunsken cheeks doctor , but iam just 24 it's the age to get fat transfer or any side effects are there doctor🙄
Hi Pavi Thra,
24 is a very young age, so you should not be experiencing age-related volume loss, and it is not the right age for these types of treatments. Fat transfers are generally unpredictable because 30-70% of grafted fat is metabolized soon after surgery because grafted fat needs to take to a new blood supply, as explained in detail in the video. I hope this clarifies things for you.
@@AmiyaPrasadMD okay doctor if I gain weight my face volume can regain doctor
Hi@@pavithra691,
I can't recommend weight gain without knowing if you had prior weight loss that affected your facial volume and appearance. The thing about gaining weight to improve facial appearance is that you also gain weight in other parts of the body, which depending on the person, can be unhealthy. I hope this clarifies things for you.
@@AmiyaPrasadMD then 🥺what is the solution 😭 doctor iam very much worried about this pls suggest me something
@@AmiyaPrasadMD actually my father also in this age losed volume in face doctor after 3 to 4 years he automatically gained volume .my facial volume is also losed bcoz of my gene