Q.How does fat grafting make the face look smaller?
A.It follows the same visual principle by which a sphere appears smaller than a flat circle of the same diameter. The clearer the contrast between highlight areas and shadow, the more the contours appear to converge, creating the perception of a smaller, more refined face. When the zones that should catch frontal light — forehead, anterior cheeks, temples, and chin — deflate with age, the face tends to look flatter, larger, and older. Fat grafting aims to restore these highlight zones so the face regains a more three-dimensional and youthful impression. Projecting the chin forward also shortens the apparent profile length, making the chin look relatively shorter and contributing to an overall more youthful appearance.
Q.What is PRP and why is it used alongside the fat?
A.PRP (Platelet-Rich Plasma) is a platelet-concentrated plasma obtained by drawing a small amount of the patient's own blood and centrifuging it. It is rich in cellular growth factors — including PDGF, TGF-β, and VEGF — which help improve the survival environment of the injected fat cells. Because it is derived from the patient's own blood, there is no risk of rejection. Clinical reports indicate it contributes to improved fat graft survival rates. At AVA, blending PRP with purified fat prior to injection is our standard approach.
Q.Won't the fat simply be absorbed and disappear quickly?
A.A portion of the injected fat is naturally absorbed during the first three to six months. However, the adipocytes that survive beyond that period develop their own blood supply and integrate as the patient's own tissue, providing a semi-permanent result. To minimise absorption, AVA uses three measures: ① centrifugation to remove damaged cells, ② PRP blending, and ③ multi-layer micro-injection to maximise the vascular contact area per particle.
Q.What is the difference between micro-fat and nano-fat?
A.They refer to fat that has been refined to different particle sizes during the purification stage. Micro-fat has larger particles and is suited to areas requiring volume — forehead, anterior cheeks, and temples. Nano-fat is processed into finer particles through additional emulsification and filtration, making it appropriate for thinner-skinned areas such as the under-eye region and fine lines. Using the correct particle size for each zone produces smoother contour lines and can also help soften fine wrinkles.
Q.What are the advantages of fat grafting compared with implants or fillers?
A.All three differ in important ways. ① Material: autologous fat carries no risk of rejection or foreign-body sensation. Fillers (hyaluronic acid) are gradually broken down over six months to two years. ② Natural movement: surviving fat integrates as your own tissue and moves naturally with facial expressions, whereas implants can feel and move independently. ③ Versatility: fat grafting can address the forehead, temples, anterior cheeks, nasolabial folds, under-eye area, and chin in a single session, while implants require separate procedures for each site. That said, when a firm, defined contour is needed — such as a strong chin or nasal tip — autologous cartilage or implants may be more suitable.
Q.Where is the fat harvested from? Will there be visible scarring?
A.Fat is typically harvested from the inner thighs, abdomen, or flanks, depending on the patient's fat distribution. Because only a small quantity is needed, there is no significant change to the donor site, although a subtle contouring effect may be noticeable. The entry points are made with 3–4 mm fine cannulae and are positioned where they are covered by underwear or swimwear; with time they become virtually invisible.
Q.Can it be completed in one session, or are multiple sessions needed?
A.It depends on the individual case. When age-related deflation is mild, a single session is often sufficient. For more pronounced volume loss, or if a more substantial result is desired, two sessions spaced six months apart may be recommended. Adding fat on top of an already-established graft from the first session tends to yield more stable results. At your consultation, the degree of deflation and your desired outcome will be assessed to determine whether one session is appropriate or a staged approach is preferable.
Q.Is it beneficial to combine fat grafting with a facelift or thread lift?
A.Because ageing involves both sagging and volume loss occurring together, combining the two procedures produces a markedly greater result. A facelift (SMAS dual-plane) lifts the descended tissues while fat grafting replenishes the deflated highlight zones, achieving a three-dimensional, rejuvenated appearance that is difficult to attain with either procedure alone. Having a single recovery for the combined effect is an added advantage, which is why this combination is frequently recommended during consultations.
Q.How long is the recovery period?
A.The majority of swelling subsides within three to five days, and most patients are able to return to daily activities after about one week. A compression garment over the donor site is advised for one to two weeks. The final grafted contour settles gradually over three to six months, so a full assessment of results is recommended at the six-month mark. Closure marks are minimal and become virtually imperceptible over time.
Q.Are there any side effects or precautions to be aware of?
A.Common post-operative reactions — swelling, bruising, and temporary numbness — resolve naturally. Rare potential complications include asymmetry, cyst formation, and infection; AVA monitors graft progress at scheduled follow-up visits to allow early management if needed. Key precautions: ① avoid applying firm pressure to the injected areas for one week post-op; ② refrain from alcohol, saunas, and strenuous exercise for one month; ③ significant weight loss is best deferred until six months post-op, as fluctuations in body weight before the graft has fully settled can affect results.
