Facial fat grafting

Facial fat grafting (facial fat transfer or lipofilling) uses the patient's own fat to restore selected areas of facial volume and improve contour. Ageing affects more than the skin alone — facial fat reduces and descends, the underlying bone provides less support, the supporting ligaments weaken, and the skin thins. The face may come to look flatter, hollow or tired. The aim of treatment is a softer, balanced and natural-looking result rather than an overfilled appearance.

Anaesthetic: Local, sedation or general
Hospital stay: Usually a day case
Time off work: 1–2 weeks
Final result: Assessed at 3–6 months

A general guide only — your own timeline is confirmed at consultation.

What it involves

Fat is removed from a donor area such as the abdomen, flanks or thighs through small incisions using a narrow liposuction cannula, then prepared to remove unwanted fluid, oil and damaged cells. It is placed back into the face in small amounts across several tissue layers, through fine cannulas or needles, so the fat cells can establish a new blood supply. The amount placed often differs between the two sides to improve existing asymmetry. Performed alone it usually takes one to two hours, under local anaesthetic, local anaesthetic with sedation, or general anaesthetic depending on the areas treated and whether other surgery is combined.

Who it may suit

May suit patients with facial volume loss or hollowing — temples, cheeks, the transition beneath the lower eyelids, folds around the nose and mouth — who have a suitable donor area and would prefer their own tissue to a synthetic filler. It is also used to improve facial asymmetry, depressed scars and contour irregularities after injury, previous surgery or medical treatment. Volume loss that is new, one-sided or progressing quickly should be medically assessed before any cosmetic treatment is considered. Dermal fillers, skin resurfacing and other non-surgical options suit some patients better, and fat grafting is often combined with a facelift, neck lift, eyelid surgery or brow lift rather than used alone.

Recovery

Swelling and bruising are expected, and swelling may initially make the face look overfilled or uneven. Rest with the head elevated, avoid pressing or massaging the treated areas, and avoid sleeping directly on them. Most patients need about one to two weeks away from work and social activities, although visible swelling or bruising can last longer. The donor area may feel bruised, tender or numb, and a compression garment may be recommended for it. Swelling settles over several weeks, and the result continues to develop as the transferred fat establishes a blood supply and the body absorbs what does not survive — the final result is usually assessed at three to six months.

This page is a general guide. Every procedure is planned individually — the details, risks and recovery relevant to you are discussed at consultation.

Patient information leaflet Download the full facial fat grafting leaflet (PDF)

Common questions

What is the difference between microfat and nanofat?

They are prepared differently and do different jobs. Microfat consists of small parcels of fat that retain living fat cells and is used to restore structural volume — hollow temples or cheeks, deeper depressions, facial contour. Nanofat is filtered into a much finer preparation containing few or no intact fat cells; it does not provide reliable structural volume and is used more superficially, aiming to improve fine lines, skin texture and skin quality. Neither is automatically better — the appropriate preparation depends on whether the main problem is volume loss or skin quality, and in some patients a combination is planned across different tissue layers.

How much of the fat lasts, and will I need a second procedure?

Not all transferred fat survives, and the amount that does varies between patients and between areas of the face. Survival is influenced by the donor fat, the technique, the blood supply in the treated tissues, nicotine use, previous scarring or radiotherapy and later weight change. Some patients need more than one procedure to reach the desired correction. Further fat is generally not added until swelling has settled and the first result can be properly assessed.

Is it safer than a synthetic filler?

Because the fat is the patient's own tissue there is no risk of an allergic reaction to it, and the improvement may be longer-lasting. It is still surgery, with its own risks — swelling, bruising, asymmetry, lumps or firm areas, fat necrosis, and uncommonly infection or the need for revision. All facial injections, fat and filler alike, also carry a rare but serious risk of fat or filler entering a blood vessel, which can cause skin loss or injury to the eye or brain. This is why placement, depth and the areas treated are planned carefully. The full range of risks is set out in the patient information leaflet and discussed at consultation.

Can the fat change later?

Yes. The fat that survives behaves like fat elsewhere in the body, so it may reduce with significant weight loss and increase with significant weight gain. Facial ageing also continues after treatment — fat grafting restores volume, it does not stop the process.