It is well-known that our faces become looser and that certain areas “sag” or “droop” with age. Recently, however, studies have proven that many people lose volume in the face as well. This is primarily related to atrophy of the fatty tissue in the cheek and lower eyelid regions, which is associated with a youthful facial contour.

Facial fat grafting (microlipoinjection or autologous fat grafting) is a cosmetic procedure that is used to treat loss of volume in the face and to restore a smoother, healthier, and more youthful appearance. Fat injections may be used to fill in the hollow areas under the eyes (“tear troughs”) and cheekbones (submalar depression). In addition, Dr. Ransom can use microlipoinjections to camouflage the laugh lines (dimples and nasolabial folds), smile lines or crow’s feet, jowl or marionette lines, and other facial creases, wrinkles, or scars. Fat injections may also be used to plump the lips. (Please see our Lip Augmentation page.)

Fat grafting is a minimally-invasive procedure and can be performed with local anesthesia or minimal sedation in an office-based facility or ambulatory surgery center. In most cases, abdominal fat is chosen as the donor site, with the incision hidden in the umbilicus (“belly button”). In some cases, based on patient preference or medical necessity, fat can be harvested from the thighs or buttocks. The donor fat is then prepared by isolating the fat cells and washing them with cold, sterile saline. Dr. Ransom then meticulously injects the purified fat cells into the recipient sites using tiny cannulas.

After the procedure, the treated area may appear puffy or swollen. Bruising and redness can also occur on both the recipient and donor sites. Despite this, patients are typically able to return to work and other normal activities immediately after treatment. Sun exposure should be avoided for two or three days. Fat injections can be long-lasting, however, results can vary depending on overall health, lifestyle behaviors such as cigarette smoking, and each patient’s unique healing capacity. In rare cases, Dr. Ransom will repeat the fat grafting procedure to ensure that his patients get the absolute best result possible. For more information about fat grafting and facial volume restoration, please contact Dr. Ransom or schedule your confidential consultation today!

Who is a candidate?

Candidates for facial revolumization (microlipoinjection) include all patients with facial volume loss, a drooping or hollow-appearing midface, and thick or deep facial folds and wrinkles. In some cases, fat grafts can be used to camouflage facial scars or revolumize areas of muscle atrophy (such as the temple region or the angle of the jaw). Many people chose to add a revolumization procedure to other cosmetic facial surgery, such as facelift, neck lift, or midface lift (endoscopic facelift). Dr. Ransom can discuss the advantages of these combination procedures during your confidential consultation.

Frequently Asked Questions

Please note that all patients are different and individual healing times and results may vary. The statements regarding procedures and recovery made here are general rules.

Facial revolumization with fat grafting is a minimally-invasive procedure, and the recovery is generally quick. Depending on the exact surgical details, including which areas are treated and how much volume is required, the down time will vary. For most patients, a couple of days off of work is sufficient. Some mild bruising and swelling will occur immediately after the surgery, but begin to resolve by the third day. The majority of this process occurs in the first week, but some patients require up to two weeks for complete resolution. Pain is very minimal. Dr. Ransom works closely with you throughout the postoperative period, making sure that you are making progress toward an excellent result. Further details can be discussed with Dr. Ransom during your confidential consultation.

Yes, though your results would likely be better if you quit smoking before the procedure. Though Dr. Ransom would strongly advise you to quit smoking to improve your overall health, smokers can undergo facial revolumization with fat grafting (microlipoinjection). Chemicals in tobacco smoke can compromise the tiny blood vessels in the body. Though the face has an excellent and robust blood supply, alterations in blood flow to the tiny fat injections can decrease the graft survival and therefore compromise your results. Dr. Ransom has a keen interest in helping patients try to quit smoking (tobacco cessation), and has even performed clinical research in this area. He would be happy to discuss this with you during your consultation, and he is able to prescribe medications to help you quit before surgery.

Many areas of the face are suitable for fat grafting, including the cheeks, under-eye area, lips, and jawline. It is very common to treat multiple areas in the same session. This gives an overall more harmonious result and is an efficient use of the fat graft tissues. In addition, fat grafting can be combined with other facial procedures, such as facelift and neck lift, to give a more comprehensive rejuvenation.

Ideally, fat grafts placed for facial volumization are a permanent alternative to injectable fillers. That said, not all of the fat that is injected stays around forever and, rarely, the procedure must be repeated. Some portions of the fat are absorbed by the body over time. In addition, the fat cells and the parts of the face where they are injected will continue to age normally. Fat grafting is an excellent, longer-lasting alternative for patients who have been getting filler treatments. In addition, it is a great complement to facelift and eyelid surgery in many patients.

Dr. Evan Ransom is an Ivy League-educated and Ivy League trained Facial Plastic and Reconstructive Surgeon. He is a Double Board Certified Head and Neck Surgeon and Facial Plastic and Reconstructive Surgery and fellowship-trained in facial plastic, reconstructive, and laser surgery. His practice is in the San Francisco Bay Area, serving patients from San Francisco, Oakland, Marin County, Palo Alto, Silicon Valley, Walnut Creek, the East Bay, and all over Northern California.