Facial Lipofilling / Fat Grafting
IN SYDNEY
Facial Fat Grafting (Autologous Fat Transfer)
Refined restoration of facial balance using your own fat - thoughtfully placed in precise planes. Optional nanofat for skin quality is available in selected cases.
My approach is considered, curated, and grounded in a deep understanding of facial anatomy. Planning focuses on where volume has reduced (midface, tear-trough/lid-cheek junction, temples, perioral area, jawline), skin quality, and the relationship between fat compartments and supporting ligaments. Placement is conservative and plane-specific, avoiding overfilling and respecting natural light and shadow.
What is Facial Fat Grafting / Lipofilling?
Facial fat grafting transfers small parcels of your own fat from a donor site (usually abdomen, flanks, or thighs) to areas of the face where volume has diminished. The fat is gently harvested, prepared, and micro-injected with blunt cannulas as tiny droplets to encourage integration. Because it is your own tissue, there is no synthetic implant; however, not all transferred fat will persist, and refinement or a staged “top-up” can be appropriate..
MICROFAT VS NANOFAT
What’s the Difference?
Microfat (for shape and contour)
What it is: Intact, small fat parcels prepared for structural volumisation.
Where it helps: Midface, malar highlights, temples (deep plane), chin/pre-jowl sulcus, perioral deficits, and selected tear-trough cases (with care).
Goal: Restore soft, natural contours without visible edges or lumpiness.
Nanofat (for skin quality - an emerging adjunct)
What it is: Fat that has been mechanically emulsified and filtered so it no longer contains intact fat lobules; the resulting cell-rich liquid is not for volume.
Where it may help: Early studies and clinical experience suggest improvements in fine lines, texture, and dyschromia; considered for lower eyelid/cheek junction, perioral lines, or scars.
Important context: Nanofat is not a filler and not a substitute for microfat. It is an adjunct aimed at skin quality rather than adding bulk, and outcomes vary between individuals; alternatives like laser or chemical peels are also discussed.
COMBINE YOUR FACIAL FAT GRAFTING
Balanced Planning
Facelift/Neck procedures: Microfat often complements deep plane lower facelift by restoring soft tissue highlights.
Blepharoplasty: Subtle microfat and/or nanofat can be considered to refine the lid-cheek junction (case-dependent).
Brow/Lip procedures: Volume balancing around temples or perioral area.
Skin treatments: Laser or chemical peels for texture and pigment - often staged 6–12 weeks around fat procedures.
Injectables: In selected cases, small amounts of HA filler may fine-tune detail after graft settling.
WHY CONSIDER A FACIAL FAT GRAFTING?
Who Is the Ideal Candidate?
Volume loss in the midface, temples, jawline, or perioral region.
Hollowing or shadowing at the lid-cheek junction or marionette area.
Adequate donor fat and realistic expectations (including the possibility of staged refinement).
Interest in autologous (your own tissue) options rather than synthetic fillers.
When another approach may be better:
Desire for very small, highly precise changes - consider HA fillers as a test or for fine detail.
Predominantly skin-surface concerns - consider resurfacing; nanofat is an option but is not a substitute for resurfacing in all cases.
Significant weight instability or smoking - optimisation recommended first.
WHAT TO EXPECT
From Consultation to Recovery - Facial Fat Grafting
Undergoing any facial surgery is a detailed and personalised process. From your first consultation to your final review, every stage is carefully planned to support your comfort, safety, and optimal healing.
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Your Initial Consultation
Facial and profile analysis; mapping of deflation vs ligament support; skin assessment; photography.
Discussion of microfat vs nanofat, donor sites, likely persistence, and the role of staged refinement.
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Preoperative Planning
Medication/supplement review; smoking cessation; pre- and post-care instructions (cooling, head elevation).
If combining with other procedures, agree on same-session vs staged sequencing.
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Surgery Day
Setting: Accredited day surgery or private hospital (often with sedation); select microfat-only cases can be local anaesthetic.
Duration: Typically 60–120 minutes, depending on scope/combination.
Technique: Harvest via low-pressure tumescent liposuction; processing by decanting/centrifugation. Microfat prepared for structural placement; nanofat prepared by mechanical emulsification/filtration for superficial use. Placement with blunt cannula micro-droplet technique in anatomy-appropriate planes; careful layering and contour checks.
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Week 1 Post-Op
Swelling/bruise peaks 48–72 h, improves over 7–10 days (face); donor sites feel bruised/achy.
Sleep head-elevated; cold compress as advised; short walks encouraged.
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Week 2–3 Post-Op
Settling of contours; early asymmetry from swelling typically evens out.
Most social downtime 7–14 days; exercise usually resumes ~2–3 weeks as advised.
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6 Weeks+ Post-Op
Persistent portion of fat typically declares by 3–6 months; staged refinement discussed then if desired.
YOUR RECOVERY
Postoperative Care & Follow-up
Wound/entry care: Tiny entry points on the face and one or two donor ports - keep clean/dry initially.
Donor care: Compression garment (if advised) for comfort and bruising control.
Activity: Walk from day 1; avoid strenuous exercise until cleared.
Skin care: Gentle skincare; strict sun protection.
Follow-up: Early review at 1–2 weeks, then 6–12 weeks, and again at ~3–6 months to assess settling.
SURGICAL RISKS
What Are the Risks of Fat Grafting?
Bruising, swelling, temporary numbness.
Asymmetry or contour irregularity; under- or over-correction.
Fat necrosis/oil cysts, particularly with large volumes or superficial placement of microfat.
Infection (uncommon), prolonged oedema.
Vascular compromise is rare with blunt cannulas but discussed as part of informed consent.
Donor-site issues: bruising, contour change, haematoma, or sensitivity.
Need for staged refinement in a proportion of patients..
Why Choose Dr Karagiannis for your Facial Fat Grafting?
1. Expertise & Experience
ISAPS fellowship in Ghent with Dr Patrick Tonnard and Dr Alexis Verpaele, whose experience with micro- and nanofat grafting has shaped the way these procedures are performed globally; learning directly from them informs my technique and case selection.
2. Anatomy-first Planning
Plane-specific, anatomy-led placement to respect ligamentous support and avoid heaviness.
3. Combined Approach
Thoughtful integration of microfat for contour with nanofat (when indicated) for skin quality, sequenced alongside facelift/blepharoplasty/skin therapies.
4. Continuity of Care
Clear, guideline-compliant counselling and continuity of care in accredited facilities.
Facial Fat Grafting FAQS
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A proportion of transferred fat typically persists long-term after the initial settling phase. We review at 3–6 months to consider any refinement.
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Large weight changes can influence facial volume. Stable weight helps maintain a consistent outcome.
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Fat is autologous and suited to broader volumisation; fillers can be useful for fine, highly precise adjustments or as a “test” in select areas.
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A mechanically processed, cell-rich liquid placed very superficially; it’s not for volume. It’s considered when targeting skin quality (fine lines/texture/pigment) rather than fullness.
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Not necessarily. It’s an adjunct. Depending on your goals, resurfacing may be recommended with or instead of nanofat.
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Most people are comfortable in 7–14 days for social settings; donor sites can feel tender for 1–2 weeks.
Request a Consultation
If you're considering facial lipofilling, I invite you to schedule a private consultation. Together we’ll map areas of volume loss, confirm suitable donor sites, and determine whether microfat alone, microfat + nanofat, or a staged plan best suits you.