Fillers or Fat Transfer: Which Is Better for You?

You’d like to soften lines and wrinkles on your face or fill in areas that have hollowed as you age — under the eyes or in the cheeks. And you’re not yet ready to consider a surgical treatment like a facelift or brow and forehead lift. You’ve heard that both dermal fillers and fat transfer can erase facial creases and restore lost volume. So how do you choose? Which treatment is right for you?

It’s true that both dermal fillers and fat transfer, which we call liposculpture, can add volume to areas that, as part of the aging process, have lost substance beneath the skin. And it’s true that both treatments can soften wrinkles and facial creases to restore a more youthful look. But there are important differences between the two approaches.

How Dermal Fillers Work — Their Pros and Cons

Injectable dermal fillers are a quick and relatively inexpensive treatment. Most are composed of hyaluronic acid, a substance that occurs naturally in the body, primarily in bone, cartilage and skin. Juvaderm and Restylane are hyaluronic acid fillers, and both come in different formulations for use in filling smaller or larger areas. 

These hyaluronic acid fillers deliver immediate results. You may have a little swelling at first, but that disappears in a matter of hours. The volume enhancement and wrinkle-filling effects don’t take time to develop, as some other treatments do. But the fillers are also gradually reabsorbed by the body, so the effect of the treatment fades with time. Most of the hyaluronic acid fillers last about six months to a year, after which you’ll need to repeat the treatment to maintain your new look.

Some fillers work in different ways and last a bit longer. Radiesse and Sculptra injections have the added effect of stimulating collagen production, which works to restore your skin’s foundation for a longer-lasting effect. 

So the pros of dermal fillers include the ease of the treatments, the immediacy of the results, and the relatively low cost of each injection. The cons include the impermanence of the treatments and the long-term cost of repeated injections to maintain results. 

In some cases, the fugitive nature of fillers might actually be positive. If you are trying cosmetic treatment for the first time and are worried about whether you will like the results, you might consider a single treatment with injectable fillers as a sort of trial run. If you like the way you look, you might repeat the treatment — or you might consider a more permanent way to achieve the same or better results. 

How Fat Transfer or Liposculpture Works — Its Pros and Cons

Fat transfer, or liposculpture, involves harvesting fat tissue from a part of the body where you have an unwanted excess — on the thighs or buttocks, for example — then processing the cells and injecting them where more volume is needed — to fill lines or hollows on the face or other parts of the body.

The harvesting of your fat cells is a minor surgical procedure, with stitches or medical tape to close the incision, and it takes a few days for the area to heal. The area where the fat is injected may also have swelling for a few days before settling into the desired look. That’s the downside. The upside is that the cells used to add volume and smooth wrinkles are your own, not manufactured substances. Some will be absorbed by the body, but most will remain in place indefinitely. The transfer may even stimulate additional growth over time through the action of stem cells, maintaining volume and giving the skin a healthier appearance.

The main pro of fat transfer is the permanence of the results. One treatment can last for many years. The cons include the discomfort and downtime involved in harvesting the fat cells, the several days of waiting for attractive results, and the higher one-time cost of the treatment. But over time, when the cost is compared to repeated injection of fillers, fat transfer is actually the less expensive option.

One additional consideration should be factored in when considering a fat transfer. Because it involves minor surgery, and because the transplanted cells can deplete initially, then grow, it takes a skilled plastic surgeon to deliver optimal results. 

Are you looking for long-lasting results? Can you afford a few days of downtime? Or will a quick and easy short-term treatment, repeated every few months, better meet your needs? Your answers to these questions can help you decide which type of treatment is right for you. But the best bet is to talk with a skilled plastic surgeon, who can answer your questions and make recommendations based on your unique needs. 

Dr. Richard Fleming at Beverly Hills Institute of Aesthetic and Reconstructive Surgery is one of the most skilled and experienced plastic surgeons in Southern California. Call (310) 278-8823 today or contact us online to schedule a personal consultation. 

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