Facial fat grafting looks as simple as filler from the outside, but it is a delicate operation in which living fat cells must be moved and made to survive in a new location.
1–2. Why fat grafting is genuinely difficult
The three steps — harvesting, purifying and injecting — look simple, but fat grafting differs fundamentally from filler in that the fat cells have to survive for the result to last. Injecting too little leaves insufficient volume and injecting too much can cause lumping or an unnatural look, so balance matters.
3. Are complications common?
Relatively common changes include fat absorption, asymmetry and persistent swelling. Rare but important complications include infection, fat necrosis, oil cysts and vision loss from fat injected into a blood vessel.
4. The main problems
Too little fat surviving (hollowing again), uneven results, excessive puffiness, a drooping appearance, and necrosis or calcification.
5–6. The procedure and how fat survives
It goes through harvesting → purification (centrifugation, filtration and so on) → injection. The grafted fat cells receive oxygen and nutrients from the surrounding tissue and settle stably as new blood vessels form.
7–8. Why injecting fat as one lump causes problems
Cells at the center of a lump struggle to receive oxygen and nutrients and can undergo necrosis. Injecting small amounts spread across several layers, like scattering seeds, is the key to raising survival and reducing unevenness.
12. What to check when choosing a fat-grafting surgeon
You can ask about the basis for judging which areas actually lack fat, the harvesting and purification methods, whether injection is spread across several layers, how under- or over-survival would be handled, and whether you can see cases from six months or more after surgery.
13. Symptoms to report after fat grafting
You need to be seen if one side swells severely or becomes hard, or if you have a fever or discharge. Sudden vision loss or severe headache requires emergency evaluation immediately.
What matters most in fat grafting is not how much fat was injected but how much of it was made to survive, evenly.