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Facial Fat Transfer: Feminization and Rejuvenation Surgeries

Medically reviewed by Jennifer Richman on May 30, 2025.

What Is Facial Fat Transfer?

Facial fat transfer, also known as analogous or autologous fat grafting, is widely used in gender-affirming facial procedures, offering a natural approach to enhancing volume and refining facial contours. The process consists of three key stages: harvesting, purification, and grafting.

Procedure Details: The Latest Medical Techniques and Technologies

The procedure begins with fat harvesting, which involves extracting fat from donor sites such as the abdomen, inner or outer thighs, or other parts of the face and neck. Once collected, the fat undergoes purification to remove excess oil and fluid, ensuring a viable and refined graft. Various methods may be in practice to prepare the fat for reinjection, including centrifugation, cotton gauze rolling, decantation, or filtration.

Once the fat has been purified, it is carefully injected into the targeted area to create the desired volume and shape. Your surgeon will use a fine needle to place small, evenly distributed amounts of fat in multiple layers: a technique known as microfat grafting or fat layering. This approach improves vascularization, enabling the transferred fat cells to develop a blood supply and remain viable long-term. The careful placement of fat ensures a smooth, natural-looking enhancement while reducing the risk of irregularities.

Purpose and Benefits of Facial Fat Transfer Surgery

Facial fat transfer is designed to restore lost volume and improve skin tone and texture using the patient’s own fat cells. A significant advantage of this approach is its complete biocompatibility, virtually eliminating the risk of allergic reactions. Also, since the fat is carefully reinjected through a fine needle, there is virtually no visible scarring after the incision sites heal.

Facial fat transfer provides lasting results in contrast to synthetic fillers that require frequent maintenance. Overall, this technique is generally regarded as permanent. Its combination of natural materials, a minimally invasive technique, and lasting results makes it a popular choice for cosmetic plastic surgery and gender-affirming procedures, helping individuals achieve subtle enhancement of feminized facial contours along with natural-looking outcomes.

Please note that at this time, the Gender Confirmation Center (GCC) only offers facial fat transfers to trans and non-binary patients undergoing facial feminization surgery (FFS) or non-binary facial surgery. To request a free surgical consultation, click here.

Cosmetic Rejuvenation or Anti-Aging Surgery

As many people age, facial fat naturally diminishes, leading to volume loss, sagging skin, and deeper wrinkles. Weight loss can further accentuate these changes, creating a more hollow appearance. Facial fat transfer provides an effective solution by using the body’s fat to restore volume, refine contours, and enhance skin quality, thereby reversing some of the effects of aging.

A facial fat transfer offers a longer-lasting solution to age-related volume loss by integrating with existing tissues, unlike temporary fillers that require regular touch-ups. Additionally, the transferred fat contains growth factors that enhance skin tone, texture, fullness, and the harmony of facial proportions.

Facial Feminization Surgery

Facial fat transfer is a common technique used in Facial Feminization Surgery (FFS) to enhance facial contours that may not have developed due to a first, testosterone-dominant puberty. While hormone therapy can aid in redistributing fat, the results can differ significantly from person to person. Not to mention, some transfeminine patients may seek out a facial transfer if they are unable to take estrogen hormone therapy for medical reasons. 

For example, testosterone exposure often results in a more angular forehead. A fat transfer to the temples helps create a softer, more rounded contour. Similarly, testosterone often results in less fat in the cheeks, which can give them a more hollow look. These effects can be permanently reversed with targeted fat transfer. The lips may also undergo subtle changes, like a thinner lower lip or an increased distance between the upper lip and the base of the nose. A  fat transfer can help correct and adjust the dimensions of the lips to align with the more common results of a first, estrogen-dominant puberty.

Gender-affirming surgery generally has much higher patient satisfaction rates than cosmetic procedures. Qualified candidates who undergo FFS with board-certified surgeons show improvements in mental health outcomes like reduced anxiety, depression, and overall distress related to gender dysphoria.

Is Facial Fat Transfer Right for You?

Facial fat transfer is an effective procedure for trans women and nonbinary individuals seeking facial feminization as part of gender-affirming surgery. At the GCC, it is offered exclusively as a component of FFS and non-binary facial surgery, helping to create a softer appearance to the face.

Ideal candidates for facial fat transfer should have adequate donor fat, sufficient skin elasticity, and overall good health to support healing. In addition to physical readiness, psychological preparedness is key. Patients should have realistic expectations around what a facial fat transfer can accomplish for their unique anatomy. Scheduling a free consultation with one of our board-certified surgeons can help patients make informed decisions about their options and better understand the process, outcomes, and recovery.

Areas of the Face We Can Target

A facial fat transfer can refine and enhance various areas of the face, whether for gender-affirmation or anti-aging purposes.

For gender-affirmation, facial fat transfer can help soften features affected by testosterone during puberty. 

• Temples: Fat injections in the temples help round out the forehead, reducing the angular appearance that often develops. 
• Cheeks: Cheek volume can be augmented, creating a fuller, gentler contour and mimicking the effects of estrogen on facial fat distribution. 
• Lips: Fat transfer to the lips enhances fullness and balance, particularly for individuals experiencing a thinner lower lip or increased space between the upper lip and the base of the nose. This can give the lips a more conventionally feminine appearance.

For anti-aging, facial fat transfer is a versatile option for restoring lost volume and smoothing fine lines and wrinkles. Treating the temples helps counteract age-related hollowing, while adding fullness to the cheeks reduces a sunken look and enhances natural contours. Fat transfer can also refine the jawline, creating a softer and more balanced profile. The procedure can also address marionette lines around the chin, which tend to deepen over time. Additionally, this technique is effective for improving skin texture by filling in pitted acne scars for a more even complexion.

How Facial Fat Transfer Works: Step-by-Step

Consultation and Treatment Planning

The first step to undergo a facial fat transfer surgery is requesting a consultation with one of our board-certified surgeons. During the consultation, we will review your medical history, assess your facial anatomy, and define your desired results. The surgeon will outline target areas for volume enhancement and help set realistic expectations, explaining recovery time and long-term results to ensure your goals align with achievable outcomes.

Surgery

Facial fat transfer is performed under general anesthesia for patient comfort. The procedure begins with liposuction, typically from donor areas such as the abdomen, flanks, thighs, or other areas of the face. The unwanted fat is gently removed using a thin tube called a cannula. The harvested fat is then purified via a centrifuge, ensuring only healthy fat cells are retained. After preparation, the fat is injected into specific facial areas with a fine cannula, ensuring precise placement to minimize visible scarring. Because the procedure is minimally invasive, recovery time is relatively short, with most patients resuming daily activities within a few days.

Facial Fat Transfer Recovery: What You Need to Know

After your surgery, it’s normal to experience some swelling, bruising, and tenderness at both the donor and treated areas. These side effects typically peak within the first few days. On average, the recovery period lasts about one to two weeks, with most swelling decreasing during this time, although some residual swelling may last longer. For optimal healing, follow these aftercare guidelines:

• Sleep with your head elevated to reduce swelling.
• Avoid strenuous activity for at least two weeks.
• Do not put pressure on injected areas—this includes avoiding side sleeping, which could disrupt fat integration and increase the risk of fat necrosis or fat loss in the cheeks, for example.

Understanding the Risks and Safety of Facial Fat Transfer

Facial fat transfer, like any surgical procedure, carries potential risks. However, serious complications are rare when performed by a skilled, board-certified surgeon with hospital privileges. 

Some of the most common concerns involve fat reabsorption, which can result in volume loss over time. A slight asymmetry may occur if the fat doesn’t settle evenly. Surgeons often overfill by 30-50% to account for natural absorption, though touch-ups may be necessary.

Beyond aesthetic factors, there can be inherent surgical risks. That can include bleeding, infection, and uneven or asymmetrical results due to fat necrosis, which happens when a portion of the transplanted fat fails to survive. Although these issues are rare, adhering to post-operative care guidelines is vital to prevent them. Above all, choosing a board-certified surgeon experienced in fat transfer techniques is essential. As this ensures a safe procedure and helps achieve the best results.</span>

Frequently Asked Questions about Facial Fat Transfer Surgery

Is facial fat transfer permanent? How long does facial lipofilling last?

The results of facial fat transfer are generally considered permanent. It typically takes six months for the injected fat cells to establish a new blood supply, at which point the final results become fully visible. While the procedure offers lasting enhancement, factors such as weight fluctuations and individual healing responses can influence the long-term results.

Is facial fat grafting surgery safe?

Yes, facial fat grafting is generally safe; however, it does involve certain risks, like any surgical procedure. Consulting with an experienced surgeon who understands your medical history is essential to ensure a safe procedure. This will help achieve optimal results and minimize risks like infection, nerve damage, asymmetry, bleeding, and more. 

Can facial fat transfer be covered by insurance?

Yes, facial fat transfer may be covered by insurance as part of facial feminization surgery (FFS) if deemed medically necessary to help treat gender dysphoria. Coverage varies depending on your insurance plan. It’s important to contact your surgeon and insurance provider to understand your eligibility and the specific coverage requirements. You will need to provide a letter of support from a licensed mental health professional and be on 12 months or more of continuous estrogen hormone therapy.</span>&lt;/span>

What is the difference between facial fat transfer surgery and fillers?

Facial fat transfer and dermal fillers both restore volume, but they differ in approach and longevity. Fat transfer utilizes your fat for a natural and potentially permanent result, although it requires surgery and some downtime. Fillers, which include hyaluronic acid, calcium hydroxylapatite, or poly-L-lactic acid, provide instant but temporary enhancement with minimal recovery time. The best option depends on your preference for permanence, recovery time, and material type.

Is facial fat grafting painful?

Facial fat grafting is generally not very painful. General anesthesia is used, meaning the patient will be unconscious and feel nothing during surgery.  After surgery, some pressure and temporary sensation loss may be felt, but any discomfort afterward is usually mild. After effects consist mainly of soreness, swelling, and bruising. &lt;/span>