There was a time when a person of a certain age had to choose between their face or bottom. Unfortunately, overtime we lose volume in the face and start to look a bit tired and gaunt. Hollows in the temples, cheeks and under the eyes cast unflattering shadows across the face which draw attention to any wrinkles. The only solution was to put on a few pounds and sit on your bottom.

By the late 1980s cosmetic surgeons had come up with another solution: fat grafting. Fat sucked out of the bottom/hips/belly during liposuction could be injected into the face – talk about multi-tasking!

But then along came synthetic fillers – a quick, non-surgical alternative for the time-poor generation. But how do you choose the right filler for you? (Read Surgical Vs. Non-Surgical Interventions: 6 Important Questions to Ask Yourself.)

Fat Grafting Vs. Dermal Fillers: Which Method Lasts Longer?

Fat grafting has one major advantage: it can be permanent. Synthetic fillers, by contrast, are only temporary. They are broken down and reabsorbed by the body anytime between several months and a couple of years.

Fat Grafting Vs. Dermal Fillers: Which is Safer?

Psychologically patients often feel safer using their own tissue because there is no chance of an allergic reaction. However, although fillers are created synthetically in a laboratory, there is little risk of an allergic reaction.

Fat Grafting Vs. Dermal Fillers: Which Looks Better?

Fat is injected using a multi-layered technique to help it blend seamlessly with existing fat, but occasionally lumps do occur. If they don't get smaller with time, they can either be removed or injected with a steroid.

Lumps can also occur if synthetic fillers are injected too near to the surface. Fat contains stem cells which produce growth factors to rejuvenate the texture of the skin.

Fat Grafting Vs. Dermal Fillers: Which Has More Downtime?

No contest here. Although fat grafting is a relatively minor two hour procedure, there is still considerably more downtime than with fillers because it involves two procedures:

Liposuction

Fat is sucked out from fatter areas such as the hips and buttocks under local anaesthetic. Fortunately only a small incision is needed. The fat then has to be separated from blood and other fluids. (ReadCoolSculpting Vs. Liposuction: Which Procedure is Right For You?)

Fat injections

Small amounts of the fat are injected into sunken facial areas.

By contrast, fillers are quick and non-invasive. No incisions and no anaesthetic. They can be performed quickly in a doctor's office and the results are immediate and also reversible.

Fat Grafting Vs. Dermal Fillers: Which Hurts More?

Again no contest. Fat grafting involves a hefty two-week recovery. (Learn more in Your Guide to Liposuction Recovery.)

You shouldn't feel any pain during the procedure, but you may be given painkillers for any discomfort afterwards. You might not need to stay overnight, but someone will need to drive you home. Fat grafting is generally considered a safe procedure, but surgery always carries a small risk:

  • Temporary numbness.
  • Risk of infection either at harvesting or injection site.
  • Skin necrosis/tissue death.
  • Haematoma: collection of blood under the skin.

By contrast, fillers are injected through such a fine needle that any swelling or bruising is minimal. Only a topical anaesthetic is needed because the filler is already premixed with anaesthetic.

Fat Grafting Vs. Dermal Fillers: Which is Costs More?

Fat grafting is more expensive initially because it includes liposuction, but if the fat takes then the results are permanent. Fillers are more expensive in the long run because they are temporary and will need to be repeated.

Fat Grafting Vs. Dermal Fillers: Which Has Safer Results?

Fat grafting is unpredictable because it is impossible to tell how many fat cells will take permanently and how many will die. The grafted fat has to develop a blood supply or it will be reabsorbed by the body. An experienced surgeon will make allowances for this and overfill. Doctors have recently started incorporating PRP which helps more fat cells to survive in the face. Learn more with PRP: Everything You Need to Know About Platelet-Rich Plasma Injections.)

Fat Grafting Vs. Dermal Fillers: Which Has Quicker Results?

Again, no contest. Fat grafting may involve multiple treatments, whereas fillers are often a one-off treatment. Even after the swelling and bruising have subsided, expect to wait six months to discover how many fat cells have survived.

Where Should the Filler Be Injected?

Fat grafting lasts longer in the cheeks and mid-face compared to more mobile areas such as the naso-labial folds and around the mouth. It is better at filling deeper rather than finer lines because it is injected right into the fat layer. Fat lumps can show through the fine skin under the eyes.

Fat Grafting Vs. Dermal Fillers: What We've Learned

For the time-poor generation, the immediacy and predictability of synthetic fillers must seem far more convenient. For first-timers, they are certainly more low-maintenance. They are also good if someone is lucky enough not to have any spare fat. Perhaps fat grafting should reinvent itself as part of an advanced anti-ageing treatment combined with a face lift, liposuction and PRP facial injections (better known as the Vampire Facial).

No one will ever have to choose between her face and her bottom again!