In October 2008, [Dr. Armstrong] transferred unwanted fat from my belly to replace long lost baby fat in my cheeks. A month later he performed a mini-facelift in his office with local anesthesia only. In less than a week, I was able to apply makeup and feel comfortable in public.

– Barbara Slayton, a 75 year old patient of Mike Armstrong, MD

Liposuction – Before & After

6 weeks after neck liposuction plus rhinoplasty with chin implant
6 weeks after neck liposuction plus rhinoplasty with chin implant

Fat Transfer – Before & After

Liposuction is the removal of unwanted fat under the skin using a small suction tube or cannula.  Under local or general anesthesia, the surgeon passes a cannula back and forth under the skin. The fat is pulled into small openings along the side of the cannula where little pieces break off and are removed by suction.  Nerves and blood vessels simply bounce off the blunt tipped cannula.  The incision is usually less than 1/4 inch and requires a single stitch to close. Liposuction may be performed almost anywhere in the body, but is commonly performed around the jowls, neck, trunk, or thighs.

Liposuction of the face and neck is most effective for young people with good skin elasticity. If you are less than 40 years old and have specific areas of increased fat, then liposuction may be an excellent way to sculpt an elegant jaw and neckline. If your skin feels loose near the lower jaw and neck, then you may wish to combine liposuction with a facelift.

  • It is not a weight loss procedure and is not intended to replace diet or exercise
  • The volume of fat that can be safely removed at one time is limited
  • It does not correct “cellulite,” the lumpy appearance caused by large fat lobules or dimpling of skin

Fat Grafting is transplantation of fat from one part of your body to another. Fat is first collected from an area of excess by liposuction then injected into the desired area through a small cannula.  Small injections of fat can be used to fill specific defects on the face, such as the dark circles under the eyes, or to add volume to thin lips.  With structural fat grafting, larger volumes of fat are used to restore lost facial volume in the cheeks, temples, eyebrows, nasolabial creases, and/or jaw line.

If you are athletic and over 40 years old, you are likely beginning to see some thinning in your face around the cheek bones, under the eyes, and perhaps in the temples.  Fat grafting can replace the lost volume with greater permanence compared to commercial fillers.  For many patients, fat grafting alone can restore an appearance of youthful health without major surgery. Transplanted fat retains the characteristics of the donor site and should be used only if your weight is stable. If you gain weight, the fat in your face is likely to grow.

  • Most permanent solution for volume loss in the face, since it replaces lost fat with similar tissue
  • Less predictable than injectable commercial fillers. Typically, a surgeon injects about 50% more than the desired volume to account for expected volume loss of 1/3-1/2

Risks of Liposuction & Fat Grafting

Wrinkling and skin irregularities if Liposuction is performed without a Facelift or skin doesn’t contract evenly.

Injury to Nerves or Blood Vessels is a possibility with Liposuction.

Numbness of the skin is not expected and would likely recover within a few weeks if it occurred.

Potential for over injection or under injection of fat to facial structures. Under treatment can be corrected by with additional fillers, but over treatment may be difficult to remove.

Significant swelling and bruising can linger up to a month post procedure.

Vascular occlusion is always a risk when injecting filler products.

Lumpiness or nodules can usually be prevented by thoroughly massaging the injection site for several hours.

Alternatives to Fat Grafting

Facial Implants

  • Implants, such as solid silicone or Gortex (ePTFE) brand, may be used in the cheeks, chin, jawline, or lips
  • Can last a lifetime and can be removed if medically necessary or unsatisfactory in appearance
  • Better at providing firm tissue support where the bone is inadequate, such as in the chin


  • Commercial fillers, such as Radiesse or Belotero, can be injected as a simple, non-surgical office procedure
  • Results can be seen anywhere from 6 month to 2 years after the injection procedure

Before your Procedure

Acquire the following items to promote a smooth recovery process:

  • Clean, compression wraps
  • Prescription pain medication (if indicated)
  • Bags of Ice
  • Fashionable, lightweight scarves to cover bruising (if undergoing neck liposuction)

Additional actions to take in preparing for your recovery:

  • Make sure your fridge is completely stocked & all laundry is up to date
  • Place all food items, toiletries, clothes, etc. above waist level to prevent yourself from needing to bend down
  • Analyze your calendar to make sure that you do not encounter any scheduling surprises while recovering
  • Pay your bills
  • If you have pets or children, arrange for someone to stop by and care for them if needed

Arrange to have a designated driver the day of the procedure.

Avoid using any agent that may induce bleeding or bruising beginning 1 week prior to treatment (unless medically necessary).

Day of Procedure

Getting ready tips – Shower the morning of your procedure & make sure your face is clean and completely free of any makeup. Shave the treatment area. Wear a comfortable top that is easy to wash & that doesn’t need to be removed over the head.

Payment will be requested upon arrival.

During the Liposuction procedure, you will feel pressure and slight tugging against the skin by the cannula.

During the Fat Transfer procedure, you will feel mild discomfort from the needle sticks as the fat is in injected.

After your Procedure

Facial Makeup should be avoided for 24 hours after the procedure.

Avoid the following until skin has fully healed – hot water, pools, excessive perspiration, or strenuous exercise.

Acetaminophen or Ibuprofen for discomfort.

Fever, Chills, Blistering, oozing, yellow/cloudy drainage, or pain that is not relieved by Acetaminophen are not expected & might need to be addressed.

Recovery Timeline


  • Wear a compression garment for at least a week, so that the tissues can contract around the fat that has been removed. Continued use of the elastic sling during the second and third week is advisable at home or when otherwise socially acceptable (for neck liposuction)

Fat Grafting

  • Expect significant swelling for at least the first week post procedure (sometimes until week 3)
  • Pain is usually mild with an accompanying sense of fullness or pressure
  • Final result can best be observed after at least 6 weeks