Everything You Need To Know About Fat Grafting

Added: 2026-05-24

[00:00:01]Because I think with fat grafting unlike with implants um and osteotoies it's very important to do certain things right to ensure that the fat graft actually survives in the area. Okay.

[00:00:12]Should you get infoorbital rim implants before getting fat grafting you know can a fat graft now one of the most important parts of this video is I want to talk to you guys about how to maintain graft survival. Okay, Face Metrics back today with another video.

[00:00:27]And in today's video, we're going to be walking through everything you need to know to get a successful fat grafting done. And this doesn't just apply to underey fat grafting. This is going to apply to any sort of fat grafting that you guys want to do. Whether that's, you know, superorbital fat grafting, underey fat grafting, fat grafting to the nasal labial folds, fat grafting to the jawline, or wherever it is you want to do it on the face, it's pretty similar no matter where you choose to do it on your face. Um so we're going to talk about everything you need to know to ensure that this process is as successful as possible because I think with fat grafting unlike with implants um and osteotoies it's very important to do certain things right to ensure that the fat graft actually survives in the area. Okay. So I want to walk you guys from from the beginning all the way if you need to get infras first all the way to how to make sure that the majority of the fat that's grafted into that region survives. So let's get right into this guys. So the first question I I get a lot from guys is you know should you get infraorbital rim implants before getting fat grafting? You know can a fat graft serve as a camouflage method for hollow under eyes or do you need to get infras first? And I think this answer really boils down to you know the position of your orbital vector and under eye support. So in the case of you know individuals that lack undereye support you know I think it's much better to get infraorbital rim implants with a little bit of fat grafting at the same time and then to follow up with that procedure 6 months later and do a overfill fat graft. Okay. The reason why I say this is a lot of surgeons they are unable to do a proper fat graft along with infoorbital rim implants because of you know the difficulty of of filling the fat along with adding bone support at the same time. So at the very most surgeons will be able to do a minor you know fat graft along with the infras um and you will need to get more fat grafted added later right so that's exactly what happened in my situation obviously you know as you guys know I had infoorbital rim implants placed right under my eyes for added support and while those implants and they they gave me you know better under eye support better elevation in the perorbital area uh I still had the dark circles or you know the the perorbital darkening under the eyes which is usually caused by thin skin and lack of fat padding. Okay. So right after my surgery, my surgeon I remember he clearly told the first thing he told me after the surgery was, you know, hey, you know, I did I did take some fat from your lower eyelids and transfer it under the eyes, but you might want to get, you know, more frack grafting done later in the future, right? And so that's exactly what I did, right? So about 7 to 8 months after the the implants were placed, um, I had, you know, flown over to Thailand to get, you know, fat grafting done. So I think anybody who has you know a negative orbital vector is a candidate for infraorbital rim implants first. As you guys can see this patient right here okay he has a neutral orbital vector right. However his um his under eye is is he has quite amount of perorbital darkening in this region.

[00:03:31]Okay. So this would be a candidate for fat grafting without infras as his his orbital vector is positive and he has decent support under the eyes. However, in this case, you know, this is a negative orbital vector, right? So, if your orbital vector is negative, you first need to fill in this area with an implant and then, you know, add fat on top of that to to fix the perorbital darkening. Okay? So, that's the simplest way I'd explain it. Uh, if you feel like you have bone, you know, lack bone support under the eyes, you need both infras and fat grafting, okay, done separately. But if you just have perorbital darkening and your underey support is quite good you know then I think you need to do uh both or you need to do just you know just the fat grafting without the infras okay so I think moving on to the next question this is something that I get a lot a lot of people ask this question is should you overfill right should you overfill do you do 100% fill do you do a conservative overfill what do you do okay and the answer to this question is I think that you should do a conservative overfill. I don't think it makes sense to, you know, go for, you know, a maximum overfill, right? Because that can leave your under eye area puffy and it can take a lot longer to heal.

[00:04:42]But I think going for a conservative overfill, like something like 120%.

[00:04:47]Okay?

[00:04:49]I think that's the best idea for most guys because I think, you know, that allows your your your under eye tissue to, you know, to adjust fairly quickly.

[00:04:58]Um, and it's not going to create a lot of the puffiness that overfilling will create. So, I really think the best idea is to, you know, get a get an underfill or not an underfill, but a conservative overfill. Um, and to basically, um, yeah, to to basically go for an overfill, but don't go extreme, right?

[00:05:16]So, that way you avoid a lot of the issues that come with, you know, puffy under eyes or, you know, longer recovery times. Um, another thing I want to address is a lot of guys ask, should I bulk or cut before the procedure? Now guys, I think that, you know, I think it's it's wise to be around 15% body fat or so before the procedure. Even for me, guys, I wasn't even super lean. I was like 15 14%. And they were struggling to find areas to pull fat from. Like they were literally checking my body for like 20 minutes and looking for areas to pull the fat from. And finally, they were able to do it through my thighs or my um my uh yeah, my the back of my quads. So my thighs, they were able to take fat from there. But, you know, had I been much leaner, if I was 10%, there would it would be a very difficult process to take fat and they would have likely underfilled me instead. So, guys, I don't think you should be super lean before doing this. I think you should aim to be about 15% body fat. So, if you're very lean, I recommend bulking a bit before the procedure just so they're able to take, you know, fat and and have an air, you know, area to take it from.

[00:06:18]Okay.

[00:06:20]So, in terms of where you should get fat grafting, I mean, there's a lot of different options. I I myself went to Ryan Clinic here in Bangkok. Um, and I really uh, you know, have nothing but positive things to say about the experience. I think they did a great job. I really liked how the surgeon was very collaborative with me in terms of planning the whole process out. Um, and you know, I had a great experience with them. The afterare is excellent so far.

[00:06:43]Um, I cannot recommend them enough.

[00:06:44]Okay. So, I really recommend going to Ratinance Clinic for fat grafting. I think they do an excellent job. I think they're great people and, you know, they have a great team. Okay. In terms of how the procedure is, guys, you know, I'd say that the procedure is pretty simple.

[00:06:58]Um, I had the option to either choose between local or general anesthesia.

[00:07:04]And, you know, the reason that I chose local, and most patients, by the way, go with local anesthesia. It's not common to do general for this procedure, but you know, part of the reason I did local is cuz I'm here in Bangkok by myself.

[00:07:15]Um, if you do general anesthesia, you're typically, you know, very woozy and and, you know, like unconscious even after it wears off. So, I didn't want to run the risk of being a foreign country by myself and having to go home, you know, when I'm not fully conscious like that.

[00:07:28]You know, I just didn't think it would be wise. So, I figured, you know, local anesthesia would be a lot less invasive and and easier to do. Um, I did feel a bit of pain during the procedure. It felt like, you know, like something was poking in my face. Um, but it wasn't too bad and I was, you know, in and out of of consciousness or or sleep during the procedure itself. However, there were parts of the procedure that were very unpleasant. Um, and my face felt quite sore for about a day after and after that, you know, I felt fine. But that's just my experience. Um, everyone's different. Some people may have, you know, more pain or less pain. It just depends on the person, right? So, that's that's how the experience went. Um, I'd say this is currently day four or five of my recovery so far. And, you know, so far I feel, you know, I feel fine, right? I just I just started drinking coffee again, okay, on day five. So, I'm feeling a lot better. I felt like crap for like a few days because I couldn't drink coffee. I just was tired and it was not good. But I'm feeling a bit back to normal now.

[00:08:30]Glad to get back in the swing of things.

[00:08:32]But it's going to take about, you know, according to the doctor, it's going to take about a month to start looking normal. And then it will take somewhere around 3 months, you know, 3 to 6 months or so for the full result to show, right? So, it's not it's not a quick procedure, but it's not as bad as implants. Okay? It's a lot quicker than that. I'm assuming most of the result will show around 3 months. Okay, maybe about 80% of the result just like it did with my Kanthoplasty. Okay, with the implants, I noticed that there was a lot of remodeling going on, you know, even at month seven and 8. But I think with the with the kanthoplasty that I had, it took about 3 to four months to see most of the full procedure. Um, and I believe that canthopexi will be the same or if not a little bit faster than that. Okay.

[00:09:14]Now, one of the most important parts of this video is I want to talk to you guys about how to maintain graft survival.

[00:09:21]Okay? So, when you get, you know, the fat graft in this area, keep in mind this fat is not native to the region.

[00:09:27]So, it it's going to have a hard time surviving and a lot of it is going to die out. You know, maybe up to 50% of the fat will die out. So, my current grafting stack that I'm using is, and this is all documented, you know, based on documented evidence here. You know, I have the studies listed here. I'm going to attach the studies in the bottom of the video so you guys can refer to them as well. But I'm currently taking creatine at 5 to six grams a day. Okay, here the study clearly shows that, you know, autogus fat grafting, you know, is that the survival rate of the fat is enhanced by creatine supplementation.

[00:09:58]You guys can go read the study yourself.

[00:10:00]um BPC57 you know there's no data around this in relation to fat grafting per se but I do know that it reduces inflammation which helps the fat survive better and it also helps with healing which will help with the overall you know procedure recovering recovery right now there's another study here that shows that knack can reduce oxidative stress and increase fat graph survival I highly recommend checking this out as well so I will try to add knack when I get back to the United States I'm currently not able to source it in in the country Thailand, but um I will add it when I get back to the United States.

[00:10:34]And obviously multivitamin and fish oil are just for general health. I recommend you take them. Uh but I'm not a doctor, so talk to your doctor about that. So the things I'm avoiding for the next 4 weeks are the gym. You know, obviously I don't want to burn off too many calories, and it's just not advised to be back in the gym in this time. I'm avoiding going in a calorie deficit. I'm eating about 200 calories above my maintenance. I'm not really tracking it, but I'm just eating to satiety and, you know, throwing in a bit of cheat foods here and there. So, you know, it probably puts me at about 200 uh surplus. Uh obviously, no no alcohol, no nicotine for the next month. Um there's another study here that shows you guys that, you know, essentially, you know, cigarette smoke or nicotine in general.

[00:11:15]I'm not sure if it states if it's nicotine, but guys, keep in mind, nicotine is very anti-healing, okay? It does. It's not conducive to proper healing of of of of wounds. So, it's best to just cut it out for at least four weeks post surgery. Okay. And the other thing I'm trying to limit is salt, sugar, and caffeine. Okay. In moderation, this is fine. I think the important thing is make sure to drink enough water, okay? So, you're well hydrated. And don't overdo the caffeine.

[00:11:41]I'm currently just having a cup a day, okay? But obviously, you don't want to spike your blood sugar, your your blood pressure up too high as that can interfere with the swelling and the healing as well. So, it's not ideal.

[00:11:51]Okay? So, that's basically the stack that I'm on. Now, I'm going to wait till about four 4 weeks out before I resume, you know, zins or smoking and things like that. Uh maybe even 6 weeks. Um and I'm going to continue to, you know, follow a a good diet, you know, relatively high protein diet. Obviously, not, you know, autistic or obsessive, but you know, just a normal diet with with good amounts of protein, carbs, and fats. Um and then in terms of cardio, guys, I do a little bit of light walking in the evenings, so it's really nice out here. I don't know if you guys you guys can't really see the view out here.

[00:12:23]Maybe you guys can see the view from here. Okay, but you guys can see that it's very nice out here in Thailand. Um, you know, it's beautiful country, beautiful city of Bangkok. So, I try to go for walks uh in the evenings, okay?

[00:12:38]To get my get my blood flowing and to increase circulation. So, that's one of the forms of exercise that I'm doing is some very light walking in the evenings.

[00:12:46]And I find that it's calming and enjoyable as well. Okay. So, I highly recommend walking, but make sure you're not overly sweating or exerting yourself. But that's it for the video, guys. I think if you do all the things I said, you're going to get a great result. Um, you can do the fat grafting wherever you please. Um, and and it's going to give you the best chance for for most of that fat to stay. But that's it for the video, guys. I'll see you guys next time.