Facial fat grafting restores selected areas of volume using the patient’s own tissue. It can soften transitions around the temples, eyelids, cheeks and mouth, but it does not lift descended tissues or guarantee permanent volume. The safest plan distinguishes true volume loss from tissue descent, edema and previous injectable material.
What microfat can—and cannot—do
| May help | Does not reliably correct |
|---|---|
| Temporal or forehead hollowing | Significant brow descent |
| Upper-eyelid A-frame deficiency | Excess eyelid skin or true ptosis |
| Lid-cheek and selected tear-trough hollowing | Malar edema, festoons or prominent fat bags |
| Selected cheek and perioral volume loss | Jowls, platysmal bands or neck laxity |
Adding volume to a structure that has descended can make the face heavier. When position is the main problem, Hybrid Blepharoplasty, video-assisted brow or midface surgery, facelift or neck treatment may be more appropriate.
How Dr. June performs facial fat grafting
Fat is commonly harvested from the abdomen, processed and placed in small deposits using fine cannulas. Different planes—including supraperiosteal, subcutaneous and selected intramuscular planes—may be used according to the region and objective. Periorbital grafting requires particularly conservative placement.
Microfat provides structural volume. Nanofat is more finely processed and may be considered for superficial skin-quality indications; it does not provide meaningful projection. Neither should be presented as guaranteed regeneration.
Why retention varies
Some grafted fat is reabsorbed. The portion that establishes a blood supply can persist, but retention varies with vascularity, parcel size, recipient plane, tissue quality, technique, weight change and healing. Exact survival percentages and fixed durability cannot be promised. A later refinement may be preferable to overcorrection.
Weight stability and GLP-1 medications
Transferred fat behaves like living adipose tissue. Major weight loss can reduce facial volume, while weight gain can enlarge it. Rapid loss during GLP-1 treatment may create or worsen facial hollowing. Elective planning is more reliable after weight has stabilized and medication management has been discussed with the medical and anesthesia teams.
Previous fillers and dermatologic ultrasound
Hyaluronic-acid filler, biostimulators, threads, PMMA, silicone and energy treatments can obscure the diagnosis or alter tissue planes. Dermatologic ultrasound may help map material, edema and fibrosis. Depending on the findings, grafting may be modified, staged or postponed. Hyaluronidase acts only on hyaluronic acid and cannot guarantee restoration of the original anatomy.
Risks and recovery
Expected effects include swelling, bruising, tenderness and temporary asymmetry at the face and donor site. Complications can include infection, bleeding, prolonged edema, nodules, oil cysts, fat necrosis, undercorrection, overcorrection, contour irregularity and revision. Intravascular injection is rare but potentially severe.
Early fullness reflects both graft and edema. Swelling is commonly most visible during the first days and may remain noticeable for two weeks or longer around the eyes. The result should be assessed only after tissue settling and resorption have progressed.
International planning
The preliminary plan is discussed remotely and confirmed in person. When combined with major facial surgery, treatment is performed at Hospital São José. Belvivere generally plans at least 15 days in Brazil after major facial procedures. The concierge service assists with logistics; clinical care and flight clearance remain medical responsibilities.
Learn more about facial fat grafting and microfat versus nanofat.
This article is educational and does not replace an individualized medical evaluation.
