Procedure guide
How fat grafting moves your own fat to restore volume, and what results to expect.
Written by Orr Shauly, MD, plastic surgery resident. Updated .
For information and education only, not medical advice.
The short answer.
Fat grafting removes fat by gentle liposuction, purifies it and injects it in small amounts to restore volume, most often in the face and breasts.1,2 Not all of the fat survives. Across facial studies about 42% of the injected volume remained after about a year, so a second session is sometimes needed.2-4 Complications are usually minor, such as swelling and irregularities, but injecting fat into a blood vessel in the face is a rare and serious risk that technique aims to prevent.5,6
- 41.63%
- facial volume retained
- Average volume retained after fat grafting to the face at about 14 months across 43 studies and 4,577 patients.3
- 61.3%
- breast volume retained
- Average volume retained 12 months after fat grafting to the breast across 40 studies and 5,684 patients.7
- 7,494 Patients
- oncologic safety
- Breast reconstruction patients in matched studies that found no increase in cancer recurrence after fat grafting.8
- 16 Weeks
- for swelling to settle
- Time over which some facial swelling may persist after fat grafting, although most resolves within a few weeks.9
What fat grafting is.
Fat grafting transfers a person's own fat from an area with extra fat, such as the abdomen or thighs, to an area that needs volume. Because the tissue is the patient's own, it is biocompatible and can feel natural.1,5 It is used to restore lost facial volume, augment or reshape the breasts, correct contour defects and soften scars.1,2
Grafted fat must establish a new blood supply to survive. Some fat cells survive, some die and are replaced from stem cells in the graft, and some die completely, which is why the amount that lasts varies.9 For that reason, the injected fat is placed in many small, separate deposits rather than large pockets.2,9
Nanofat is a mechanically processed fat used for skin quality rather than volume, and it is covered in a separate evidence guide.
Who is a candidate.
Candidates have enough fat to harvest and an area that would benefit from added volume, with realistic expectations about how much will last.9 People planning significant weight loss are advised to reach their goal first, since grafted fat changes with body weight.9
Blood thinners and some supplements increase bleeding risk, and people with a history of cold sores receive antiviral medication before fat is grafted around the mouth.9
Fat grafting techniques.
| Method | How It Works | Evidence |
|---|---|---|
| Centrifugation10,11 | Spins the fat to separate oil and fluid | Widely used, with lower long-term retention than washing and filtration in some studies |
| Washing / Filtration10 | Rinses and filters the fat, often in a closed device | Better long-term outcomes than centrifugation or settling in a review of 2,413 patients |
| Gauze Rolling11 | Wicks oil and fluid away on absorbent material | More viable cells than centrifugation in laboratory studies |
| Cell-Enriched Grafts12,13 | Adds stromal vascular fraction, stem cells or PRP | Higher facial volume retention in a meta-analysis of 275 patients |
Harvesting methods have not been shown to change how much fat survives, but handling matters. Textbooks advise minimal manipulation, avoiding excessive suction and exposure to air, and injecting with blunt cannulas.2,9 Volumes vary by area. In a review of facial fat grafting, average volumes ranged from 0.65 mL per side in the tear trough to 11.5 mL per side along the jaw.14
How fat grafting is performed.
- Harvest: Fat is removed with small cannulas from the abdomen, inner thighs or other areas. The donor site does not affect how long the fat lasts.9
- Processing: The fat is separated from fluid, oil and blood by spinning, rinsing, filtering or wicking.9,10
- Injection: Tiny amounts are placed in layers through blunt cannulas, which reduces the risk of nerve and vessel injury.2,9
- Combination: Fat grafting is often done with a facelift or other procedures in the same operation.14
Recovery.
Swelling is the most common issue after facial fat grafting, and the course below comes from a surgical textbook.9
| Time | What Usually Happens |
|---|---|
| Days 1 - 39 | Swelling peaks around day 3, and elevation and cold therapy are used for the first 48 hours |
| Week 29 | Bruising fades while swelling remains, and gentle massage of the treated area may begin |
| Weeks 3 - 59 | Most patients look like themselves again |
| Up to 16 Weeks9 | Some swelling may persist as the fat settles |
Pressure on treated areas, such as from glasses or hats, is avoided early because it can displace newly placed fat.9
Risks and complications.
| Complication | Reported Rate | Context |
|---|---|---|
| Facial Complications3 | 2.27% | Mostly asymmetry and irregularities across 4,577 patients |
| Breast Complications7 | 25.9% | Mostly minor radiologic or palpable findings, especially fat necrosis |
| Fat Necrosis, Breast Imaging7 | 8.8% | Benign findings without impaired cancer detection |
| Bruising After Temple Grafting4 | 43.68% | The most common event after temple grafting |
The most serious risk in the face is fat entering a blood vessel and blocking it, which can cause vision loss, stroke or death. Reviews describe it as rare but disproportionately severe.5,6 In a review of temple fat grafting in 1,239 patients, 22 serious embolic events were reported, so technique, blunt cannulas and slow, low-pressure injection are emphasized.4,9
Lumps, oil cysts and fat necrosis can appear weeks to months after facial grafting, most often around the eyes, and are usually treated with steroid injections, observation or, rarely, surgery.15 Fat can also migrate where muscles move, such as between the brows.9
In breast reconstruction, matched studies of 7,494 patients found no difference in local, regional or distant cancer recurrence with fat grafting, and fat grafting after radiation did not increase complications or recurrence.8,16
Results and how long they last.
The fat that survives the first months behaves like the patient's own fat and can last long term, changing with weight. Because some resorbs, a second session is often needed.2,9 Retention averaged 41.63% in the face and 42.11% in the temples at about a year, and 61.3% in the breast.3,4,7
Satisfaction is high. In breast fat grafting, pooled satisfaction was 93.1%, and grafts enriched with stromal vascular fraction or PRP retained more volume, though evidence is heterogeneous.7
Alternatives.
Hyaluronic acid fillers, covered in a separate guide, restore smaller amounts of facial volume without surgery. For the breast, implants gave higher overall satisfaction than fat grafting in a meta-analysis of BREAST-Q scores.17
What we don't know yet.
- Best Processing: No single processing method has proven superior in clinical outcomes.10,11
- Enrichment: Whether stem cell or PRP enrichment reliably improves results needs larger randomized trials.12,13
- True Complication Rate: Facial complications are inconsistently defined and reported.5
- Standard Volumes: How much fat to inject in each area is not standardized.14
Common questions.
How long does fat grafting last?
Fat that survives the first few months tends to last and changes with body weight. Across facial studies, about 40% of the injected volume remained after about a year, so a touch-up session is sometimes needed.
Is fat grafting better than filler?
Each has advantages. Fat is your own tissue and can last long term, but it needs liposuction and has a recovery period. Hyaluronic acid filler requires no surgery and can be dissolved, but it is temporary.
Can fat grafting enlarge my breasts?
Fat grafting can provide a modest increase in breast size. About 61% of the injected volume remained at 12 months in a large meta-analysis, and satisfaction was high, although overall satisfaction was higher with implants in another meta-analysis.
Does fat grafting to the breast affect cancer screening?
Fat grafting can create benign findings such as fat necrosis or calcifications on imaging. A meta-analysis found no evidence that it impaired cancer detection, and matched studies found no increase in cancer recurrence after reconstruction.
Is facial fat grafting safe?
Most complications are minor, such as swelling or irregularities. The rare but serious risk is fat entering a blood vessel, which is why careful technique with blunt cannulas and small injections is used.
When can I return to work after fat grafting?
It depends on the area treated and the amount of swelling. After facial grafting, most patients look like themselves again in about 3 - 5 weeks, and your surgeon can give a personal estimate.
Is fat grafting right for me?
Only an in-person evaluation can answer that. This guide is educational and cannot assess an individual case. A qualified plastic surgeon can review your goals, anatomy and health history with you.
Key terms.
- Fat Grafting
- Moving a person's own fat from one area to another to restore volume or contour.
- Lipofilling
- Another term for fat grafting.
- Graft Retention
- The portion of injected fat that survives long term.
- Stromal Vascular Fraction
- A mix of cells, including stem cells, separated from fat and sometimes added to grafts.
- Fat Necrosis
- Death of grafted fat cells, which can form firm lumps or oil cysts.
- Fat Embolism
- Fat entering a blood vessel and blocking blood flow, a rare but serious complication.
- Blunt Cannula
- A rounded-tip tube used to inject fat that lowers the risk of piercing vessels and nerves.
- Nanofat
- Mechanically processed fat used to improve skin quality rather than add volume.
Research by Dr. Shauly on this topic.
References.
- 1.Shauly O, Gould DJ, Ghavami A. Fat Grafting: Basic Science, Techniques, and Patient Management. Plast Reconstr Surg Glob Open. 2022;10(3):e3987. PubMed
- 2.Chang EI. Fat grafting in plastic surgery. In: Chung KC, editor. Grabb and Smith's plastic surgery. 8th ed. Philadelphia: Wolters Kluwer; 2020. p. 488-92.
- 3.Gornitsky J, Viezel-Mathieu A, Alnaif N, Azzi AJ, Gilardino MS. A systematic review of the effectiveness and complications of fat grafting in the facial region. JPRAS Open. 2019;19:87-97. PubMed
- 4.Friedmann DP, Hinchee-Rodriguez K, Verma KK. Temple Volumization With Autologous Fat: A Systematic Review of the Literature. Dermatol Surg. 2025;51(10):959-66. PubMed
- 5.Schiraldi L, Sapino G, Meuli J, Maruccia M, Cherubino M, Raffoul W, et al. Facial Fat Grafting (FFG): Worth the Risk? A Systematic Review of Complications and Critical Appraisal. J Clin Med. 2022;11(16):4708. PubMed
- 6.Han Y, Liu C, Wu G. Cerebral Complications Following Facial Autologous Fat Graft Injection: A Systematic Review and Meta-analysis. Aesthetic Plast Surg. 2024;48(22):4675-86. PubMed
- 7.Gentile P, Sterodimas A. Autologous Fat Grafting for Breast Augmentation and Breast Remodeling: A Systematic Review and Meta-analysis of Complications, Radiologic Outcomes, Graft Retention, and Patient-Reported Satisfaction. Aesthet Surg J. 2026. doi:10.1093/asj/sjag187. PubMed
- 8.Li M, Shi Y, Li Q, Guo X, Han X, Li F. Oncological Safety of Autologous Fat Grafting in Breast Reconstruction: A Meta-analysis Based on Matched Cohort Studies. Aesthetic Plast Surg. 2022;46(3):1189-200. PubMed
- 9.Broughton G 2nd, Coleman SR. Fat grafting. In: Janis JE, editor. Essentials of aesthetic surgery. New York: Thieme; 2018. p. 297-312.
- 10.Langridge BJ, Jasionowska S, Khan H, Awad L, Turner BRH, Varghese J, et al. Achieving optimal clinical outcomes in autologous fat grafting: A systematic review of processing techniques. J Plast Reconstr Aesthet Surg. 2023;81:9-25. PubMed
- 11.Tuin AJ, Domerchie PN, Schepers RH, Willemsen JC, Dijkstra PU, Spijkervet FK, et al. What is the current optimal fat grafting processing technique? A systematic review. J Craniomaxillofac Surg. 2016;44(1):45-55. PubMed
- 12.Karam M, Abul A, Wood B, Kahlar N, Naik A, Tay J, et al. Stem Cell-Enriched Fat Grafts Versus Autologous Fat Grafts for Facial Reconstruction: A Systematic Review and Meta-analysis. Ann Plast Surg. 2023;90(5):487-93. PubMed
- 13.Hasiba-Pappas S, Opriessnig E, Nischwitz SP, Winter R, Mandal P, Carnieletto M, et al. Optimizing Autologous Fat Grafting: A Systematic Review of Enhancement Strategies and Graft Survival. Aesthet Surg J. 2025. doi:10.1093/asj/sjaf242. PubMed
- 14.Shue S, Kurlander DE, Guyuron B. Fat Injection: A Systematic Review of Injection Volumes by Facial Subunit. Aesthetic Plast Surg. 2018;42(5):1261-70. PubMed
- 15.Jerliu A, Watters A, Harrison L, Hughes CD, Babigian A, Castiglione C. Fat Necrosis After Facial Autologous Fat Grafting: A Systematic Review of Reported Complications and Management Strategies. Aesthetic Plast Surg. 2026. doi:10.1007/s00266-026-06047-z. PubMed
- 16.Chen Y, Li G. Safety and Effectiveness of Autologous Fat Grafting after Breast Radiotherapy: A Systematic Review and Meta-Analysis. Plast Reconstr Surg. 2021;147(1):1-10. PubMed
- 17.AlGhanim K, Minkhorst K, Jaszkul KM, Keelan S, Appleton S, DeLyzer T, et al. Fat Grafting Versus Implants: Who's Happier? A Systematic Review and Meta-analysis. Plast Surg (Oakv). 2025;33(1):23-34. PubMed