Your own fat
instead of hyaluronic acid

Fat is also a filler. How fat grafting works, how it differs from hyaluronic acid, and when each method is more suitable.

When the face loses volume, hyaluronic acid filler is usually the first thing that comes to mind. But there is another kind of “filling”, which is your own fat. This is fat grafting (lipofilling) — the transfer of fatty tissue from one part of the body to another. Fat is also a filler (from the English “filling”), only a living one.

How it is done

• A small amount of fat is taken with a fine cannula from the abdomen, flanks or thighs (a small liposuction).
• The fat is purified of blood and fluids.
• It is injected in small portions, in several layers, with fine cannulas, into the areas where volume is needed.
• The procedure is under local anaesthesia for small volumes or general anaesthesia for larger ones, and can be combined with another operation.

Hyaluronic filler: advantages and limitations

• A quick procedure, with a predictable result that is visible immediately.
• Reversible — it can be broken down with hyaluronidase.
• Temporary — between 6 and 18 months depending on the product and the area, so it has to be repeated.

Your own fat: advantages and limitations

• The material is your own — there is no reaction to a foreign substance.
• The tissue is alive: what takes remains long term.
• Part of the fat is absorbed in the first weeks and months. Exactly how much is individual and cannot be predicted precisely, so a second session is sometimes needed.
• The final result is judged after about 3–6 months.
• Swelling after the procedure is more pronounced and lasts longer.
• Taking the fat is an additional intervention, but the donor area is slightly contoured as a side effect.

When each is preferred

• Fat grafting is suitable for loss of volume in the cheeks, temples and chin, for depressed scars, for the hands, and for correcting the contour of the breast.
• Hyaluronic filler is more suitable for fine detail, such as the lips, and for quick correction.
• Neither method is “better” overall — it depends on the area, the expectations and the amount of volume.

Risks

• Swelling and bruising for up to 1–2 weeks.
• Irregularities, firm areas (oil cysts), asymmetry.
• Overcorrection or undercorrection — which is why the fat is placed in small portions and assessed carefully.
• Rarely, but seriously — blockage of a blood vessel when injecting into high-risk areas (between the eyebrows, the nose). That is why the area, the technique and the experience of the doctor matter.
• Smoking worsens the survival of the grafted fat.

What cannot be promised

An exact percentage of fat survival and a guaranteed permanent volume. What can be promised is a careful technique, a realistic assessment and correction if needed.