Q. I had fat grafting to my face when I got a facelift. Six weeks later, I've noticed my face is not as full as it was. I also see asymmetry. Is this normal?

A. It is common to experience some degree of asymmetry and reduction in fullness following fat grafting to the face. Immediately after the procedure, the treated areas often appear fuller due to swelling and the presence of more fat cells than will ultimately survive.

Typically, some of the transplanted fat will be reabsorbed by the body in the weeks following the procedure, leading to a decrease in volume.

Asymmetry can also occur as different areas of the face may reabsorb the fat at varying rates. This is a normal part of the healing process. Usually, about 50-70% of the transferred fat survives long term, with the rest being naturally absorbed.

It's important to wait several months before evaluating the final results, as the fat that remains after this period is generally permanent. If the asymmetry or volume loss persists and is concerning, a follow-up consultation with your surgeon is advisable.

They can assess whether additional fat grafting or other corrective measures might be needed to achieve your desired results.

I often will discuss with my patients how they can use long-term fillers rather than fat grafting. In my experience, fillers, while not lasting as long as fat, are generally more precise and more predictable than fat grafting.