How long do Fat injections last? Are they permanent?

Although I have addressed this subject in the past, the question pops up so often means people are still confused about how fat grafts work. The question so often asked is “How long do fat grafts last?”.

The short answer is that when fat grafts are done with proper technique, they are permanent. This is not opinion, this is fact.

There is sufficient experimental and clinical data to to say what the proper technique is for doing fat grafts. Do not accept the word of a doctor that tells you fat grafts are temporary, or that you will need touch ups. The facts are otherwise.

Successful fat grafting depends on 4 things

  1. Collecting the fat in a way that will keep most fat cells alive.
  2. Processing the fat in a way that gets rid of unnecessary elements, such as dead cells or excess fluids.
  3. Injecting the cells in a way that will optimize fat graft survival.
  4. Protecting the cells after they have been injected.

Collecting the fat has to be done in a way that does not harm or kill the fat cells. The fat cells are extracted by placing a hollow tube (cannula) with a hole near its tip into your fat tissues. You then apply suction thru the cannula so fat cells are sucked thru the cannula into your receptacle. Experimental evidence is clear that in order not to damage cells, suction pressure should be less than 20 mmHg. Cells are gentle organisms and the suction exerted by most liposuction machines can damage cells. By using a syringe liposuction technique, where suction is applied just by drawing back on the plunger of a syringe, high suction pressure is avoided.

Processing the fat is another key point. The key is to separate out good live cells from all other components of the extracted sample. Some surgeons rinse the fat. This does not get rid of dead cells. Rinsing the fat also does not get rid of the rinsing fluid itself! Any graft cell takes best when there is a minimum of excess fluid around it. Some other plastic surgeon put the cells thru a strainer. This does not get rid of most of the fluid nor debris, nor dead cells. The worst (!) is when they put the cells on some gauze or fabric to act as a strainer. The fat can then pick up lint that acts as an irritant. Again, experimental and clinical evidence has shown that the best method to purify the fat cells is centrifugation. Centrifugation, where fat cells are spun at high speeds separates the cells from fluids, debris, and dead or weak fat cells. There are well defined parameters for speed and timing of centrifugation. Centrifugation also has the benefit of increasing the proportion of stem cells in your injectable fraction. 

Different cannulas used for fat injection.
cannulas used for fat injection

Injection technique is important. Cells should be injected under low pressure, so as not to injure them. They should also be injected in very small droplets so the surrounding tissues can get the blood supply quickly into all the injected fat. When you inject fat in large clumps only the fat cells on the outside of the clump get blood supply on time. The rest of the cells inside the large clump starve of blood supply and die. When they die they release their contents, which in turn causes an inflammatory reaction in the tissues.This inflammatory reaction can interfere with the blood supply of the cells which had taken, and cause scarring. Injecting in small droplets is slow and tedious, but necessary to ensure graft survival.

Protecting the cells after they have been injected is the last step in ensuring graft survival. The key is to prevent swelling and trauma to the area. In the body, I use compression garments and give instructions to the patient not put pressure or lay on the area where we grafted. The area is protected for three weeks. Three weeks is important not just because of the time needed for the graft to take, but for the supporting tissue scaffold to mature. In the face, I advise patients to sleep with the head of the bed elevated to prevent swelling, and to sleep on their back so as to avoid trauma from awkward sleeping positions. Finally, I prescribe a short course of steroids, as it cuts down on local swelling and acts as an anti inflammatory.

All the problems encountered by different practitioners, such as infections, fluid collections (seromas), scarring, disappearance of graft. etc., can all be traced to technical deviations to the steps described above. There are many who say fat grafts are temporary or they don’t last. Don’t take their word, there is plenty of accumulated laboratory and clinical data to refute them.

By Dr. Ricardo L. Rodriguez MD Board Certified Plastic Surgeon Cosmeticsurg Baltimore, Maryland Ricardo L. Rodriguez on American Society of Plastic Surgeons.

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44 thoughts on “How long do Fat injections last? Are they permanent?”

  • Michael says:

    I have my ears stretched to 35mm. My first problem is that I have a blowout on both ears. I have been wearing silicone tunnels that allow me to tuck the extra skin so that it is unnoticeable. I was hoping it would absorb back into my ear, but so far it has not. I have read a lot about people having the blowouts scalped off. I am trying to gather some information and possibly have a virtual consultation. My second issue is I notice on both ears that the lobe is thinner on one side. I was wondering if something could be done to thicken that section up to match the rest of the lobe. Injection possibly? Fat graft? Please any information would be greatly appreciated.
    • Dr. Ricardo L Rodriguez says:

      To really understand your problem we will need to do a virtual consult with photos. Contact Leeza at for details on how to get in contact in a formal consult so I can give you my time and examine things in a meaningful way other than online opinion.
  • Debbie says:

    I am thinking of doing fat transfer to my face. Can you recommend a very skilled surgeon in or around the Columbus, Ohio area. I would be willing to drive a distance to see someone highly recommended.
    • Dr. Ricardo L Rodriguez says:

      Debbie: We do many patients from out of town. Unfortunately it is very hard to know what each other surgeon does or how effective he is even in my own hometown. You will just have to ask many people (not just a few friends who may have had surgery with the Doctor), read Real Self (online site) reviews, etc.
  • s says:

    Hello! 1. What if the face or butt injection cannula is used for fat injection into the breasts? 2. What if the doctor has done several fat transfer procedures to the face and butt with pretty good results but hasnt done any to the breasts and yet says that he can do it successfully for breasts? Can I trust him? Does not use PRP nor stem cell technique.
    • Dr. Ricardo L Rodriguez says:

      S I use a 1.2mm diameter cannula for the face. The cannula I use for the butt is not much larger. But both are internally treated to prevent further damage to the fat fragments. A careful and successful fat grafting surgeon is capable of doing it to various sites, I have done it many times at all three sites, but into several areas (feet, lower legs) much less frequently. What really matters is how you process the fat fragment. I do not use prp. PRP will not rescue a bad graft nor will it improve a good fat graft. I am president of IFATS (International Federation of Adipose Therapy and Science) and have reviewed several articles of fat + prp. I am receptive to the idea but not yet persuaded. As for stem cells, isolation of stem cells is explicitly not approved by the FDA, and anybody doing it is skirting the law. Hardly and endorsement. I do think stem cells help, and I am conducting a study using stem cells + fat grafts in radiated breasts. It is an FDA approved study. Many people say "IRB approved", and there are a lot of shady operators using those terms, especially in Florida and California.
  • IAF says:

    I had a BBL with Dr Rodriguez 4 years ago. Best money spent ever!!! I love my body. I can even order cloths online, which is something that I was never able to do. Do your research - he is the best in the area!!! I drove two hours and spent good money but I can say that hands down this was the best investment I made FOR ME! Four years later and my body is still amazing!
  • susan spatz says:

    I need fat injections under my eyes for hollowing from a lower blepharoplasty in 2012. Dr Robert Fruend in Nyc would be my choice , he developed viafill method ,what do you think ,it is supposed to be an enclosed system so the fat does not breakdown due to fragility. have you heard of this method or him ??
    • Dr. Ricardo L Rodriguez says:

      Susan: I have not heard of him. I have heard of viafill. The best authority on fat grafting in NYC is Dr. Sidney Coleman. He is THE pioneer in the modern technique of fat grafting. I am the president of the IFATS society and he is a past president, he has published several textbooks on the subject, and his reputation is international.
  • Aso says:

    How expensive fat injection for hand and wrists?Is it possible to take silicone on wrists instead fa t injection?
    • Dr. Ricardo L Rodriguez says:

      Aso: I really would try to avoid silicone injection to wrists. The first reason is that the fat may slide along tendon sheaths and end up in unpredictable places. It is also dangerous because if the body forms a capsule around the silicone (it always done, and it may be thin or thick) the mass effect can be a problem. The wrist has a very tight spacing and any mass effect may compress the nerves. Fat injections in this area when done correctly have a safety record. I will have Kelly at contact you for more details. Thank you for your interest.
  • Mais says:

    I had fat graft to my cheeks 6 months ago, fat was injected at bottom cheeks, near the mouth and at the nasolobian lines! Result is awful In addition to the soft fat resulted from the injected fat, some fat lumps are there! I need to take the fat out and restore my old look! What would be the best way? Excision through an Intraoral incisions or microliposuction? Thank you
    • Dr. Ricardo L Rodriguez says:

      Mais: I am sorry about your bad experience. Your case seems complex. The best way for me to give you advice pertinent to your individual situation is to set up a virtual consultation. You can contact Kelly at In general, I would tend to think microliposuction would be better unless there are large isolated deposits that have cyst formation.
  • Kakada Thor says:

    Im from Stockton CA, I'm really trying to get a buttock fat transfer, but I'm so undecided with who to go to. I've read your quotes regarding the issue of the fat transfer. I feel that u are a great surgeon. You no so much & make so much sense with your experience. If possible is there any good surgeon that u no of that u can recommend me to in California? ??? P.s I will highly appreciate it so much. Sincerely, Kakada T.
    • Dr. Ricardo L Rodriguez says:

      Kakada: Unfortunately I would have to know the Doctor personally and have operated with him to see how he does things. Processing the fat is a very tedious and exact process and not everybody does it the same way. We do get many patients from out of town including Europe and Asia, so i encourage you to consider the possibility of travel.
  • Esther says:

    Dear doctor, in one of your video you spoke about decantating the fat before the centrifugation. You didn't mention this here. Is this step unimportant ? I'm personally interested in breast enlargement by fat graft. I saw a surgeon who told me that in all he could extract from my body about 1.5 liters of fat. What kind of augmentation would such little amount of fat allow ? How much would the operation cost in your clinic ? Thank you in advance
    • Dr. Ricardo L Rodriguez says:

      Esther: Decanting means to let the fat separate from the liquid phase. Centrifugation does it too. If you do not decant before, you end up with syringes that are mostly liquid and very little fat. It is not a problem, you just have to spend more time processing. For that reason I prefer decanting before, to get rid of a lot of fluid before centrifugation. Centrifugation removes the remaining fluid. I don't know how much fat I could extract from your body as I would need to see pictures. Contact Kelly at and she will be happy to give you more information about cost, technique, etc. She can help you set up a Skype or FaceTime session if you want to discuss further. Hope to hear from you soon!
  • Lana says:

    Hi Dr Rodriguez, I'm a 27 year old woman from Toronto, Canada and I was considering getting fat grafts (not in TO as I'm afraid the technology for this procedure isn't up to snuff like in Europe and the US) for my blueish under eye hollows. Would you recommend it for someone my age and for under the eyes and is it SAFE? Thank you in advance!
    • Dr. Ricardo L Rodriguez says:

      Lana: The bluish discoloration is due to two things, one is hyperpigmenation from chronic irritation, or thinning of the dermis layer letting the underlying eyelid muscle color show thru the skin. I have done this several times with young people. It is safe when a surgeon is skilled in the procedure. We'd love to help you, we have had several Canadian patients. Contact Kelly at
  • Claudia says:

    Hello Dc.Rodriguez I would love to have fat grafting done to my hips. I live out in Hawaii and I'm not sure if the doctors out here will take the time to do the grafting the right way. How can I make sure the doctor I end up with will take the time to graft the fat with care. I feel this way because most doctors do say the fat will die and you will end up having to do this again. I just want it done right the first time... Than you for reading!
    • Dr. Ricardo L Rodriguez says:

      Claudia: I have done patients from Hawaii and even Singapore. When you want things done right, go to someone who does it a lot and does it in a reliable way. I don't know who does it reliably in your area. It is delicate and time consuming work so not many people do it well. Even in the east coast, lots of people charge very low fees, but they warn patients that they "may" need a "touch up". If they are saying that, it means their grafts are a crap shoot. I can tell you this, I have done over 350 of these, and I have not had graft failures. Patients who have come back for more (literally a handful- not more than 5) have gained weight on purpose so I can do extra lipo and add grafting to the buttock. Contact Kelly at we can always do a virtual consult Oh and by the way sorry for the delay, we get a lot of posts and sometimes I forget to check the back pages. I hope this helps!
    • Dr. Ricardo L Rodriguez says:

      Connie: Yes, we have done it several times. It is not as common as you would think because it is more expensive than just breast implants and most people are just happy with implants. Of course, fat injections are a lot more natural and they are your own tissue, so I think it's better, but each patient has to decide for herself. We'd love to help you and you can contact Kelly at for more info.
    • Dr. Ricardo L Rodriguez says:

      Shosho: Surely it was not done by us. There are many reasons why a fat graft won't last. The fat has to be removed carefully at low enough pressure. It has to be processed the right way. It has to be injected the right way. Any deviation from proven methods means reduced survival of the fat cells. Let us know if we can help you.
    • Dr. Ricardo L Rodriguez says:

      Kawthar: We do a lot of it, we see great results, and the patients love it. It really is one of the most satisfying things we do. Contact Kelly at, she'd love to help you!
  • jodie says:

    Had fat injections on cheek bones, smile lines and either side of mouth, been 3 weeks, still can not smile and move upper lip? what is causing this and will it ever go away? Been very depressing.
    • Dr. Ricardo L Rodriguez says:

      Jodie: It will probably resolve gradually. 3 weeks is very soon after surgery, swelling is still not down. What happens is muscles are surrounded and sometimes even infiltrated with newly injected fat. They will take a while to regain full motion, but they will. Cheer up, I bet you will look great and it will be alright very soon! God bless you!
    • Dr. Ricardo L Rodriguez says:

      Jauna: That depends on the patient. I would have to see pictures of the patient and then decide. I have done cases where I inject just into the hips, most of the time I inject into hips and buttocks. Thanks for visiting our blog!
  • jauana hanks says:

    Do you perform hydrogel injections. Can I have more than 3 areas lipo to round the hips off for the brazilian buttlift also i want a tummy tuck with this procedure.
    • Dr. Ricardo L Rodriguez says:

      Jauna: The patient in this video had exactly what you are thinking off- tummy-tuck, lipo of 3 areas, and brazilian butt lift. You too could have a great result! Kelly should be getting in contact with you soon. We'd love to hear from you!
    • Kelly Warner says:

      Hi Jauana, thank you for posting regarding your interest in the tummy tuck and brazilian butt lift procedure. Dr. Rodriguez specializes in multiple procedure surgery performed with iv-sedation (twilight anesthesia) and would be delighted to meet you in his new facility. Yes, you may have more than 3 areas of liposuction and specify where you want to have the fat transferred, the procedure is unique to everyone. The cost range for tummy tuck with the brazilian butt lift/fat injections (all inclusive) is $23,000 to $28,000. Please call the office for more details and to schedule a personal consultation with Dr. Rodriguez. Thank you, Kelly Warner Patient Coordinator 410-494-8100
  • danielle says:

    hey Doc, thnks for all the precious info 1: is it true that sometimes more than a fat injection procedure is needed to get the aimed look ?? and wut if we lose weight,do we lose these fats? 2: wut r the disadvantages of the cheek implant? do they cause infections or move from there place after long time?and the long term body reaction towards them?? thanks
    • Dr. Ricardo L Rodriguez says:

      Danielle: If done correctly, you should need only one procedure. Having said that, I have had a few patients that just wanted a very big butt, and gained weight on purpose to get a second procedure done. That works, if you are comfortable at your new weight. The way I evaluate a person before I do a fat graft is to ask the person what is the area they have most difficult time losing weight. This is the area I will target first for grafting. The fat will behave the same way once it has been grafted into the buttock, that is, the patient will lose weight everywhere else before they lose it in the buttock. See this post about this very same question. Cheek implants are nice, but they have a totally different look and feel than fat grafts. BTW, is that butt cheek or face cheek? Contact Kelly at
  • Mary says:

    My doctor told me my fat injection would not last more than 4 years.. I absolutely hate my injections in my face.. I told him I did not want that and he did it anywaylll... I am so depressed alll the time..He took the fat from my abdomin... Would that change anything.. I don't know what he did to the fat other than transfer it from my agdomin to my fact.. thanks
    • Dr. Ricardo L Rodriguez says:

      Mary: Depending on the technique used, fat can either be temporary, or stay on for many years. I have treated 2 patients with fat injections that were over done, and in both cases it was the same as in yours. The surgeon misunderstood the wishes of the patient. Luckily, I was able to treat them successfully using liposuction with a microcannula. Don't despair, your problem has a solution. If you want more in depth analysis, you might want to do a virtual consult where I can look at your pictures and tell you what the way forward is. You can contact Kelly at
  • loui says:

    hello doc , i have a question , i m a male who is willing to do the buttocks augmentation , imy only concern is that i dont have enough fat in my body to use i work out frequently and my body fat is really low however my butt is not shaped at all ! i dont want to go for the implant procedure any advices ! thanks
    • admin says:

      A lot of the issue about Buttocks augmentation has to do with proportions between waist dimension and buttock size. One may not need a lot of fat to get a desirable result if the proportions are altered the right way. To make a proper judgement, one would have to evaluate you individually, but I have done it on a very slim woman who weighed 98 pds, and she was happy with the result.
    • Dr. Ricardo L Rodriguez says:

      I do not do hydrogel injections. I do get plenty of emails and pictures from patients who have been disfigured by it. I cannot tell you what to do, but please investigate carefully before you commit to hydrogel injections.
  • Nephtali says:

    Do any Dr's offer free procedures on butt lift? in exchange of promoting their business? does this exist? if so I will like to get more info