At a glance: what is nanofat for?
Nanofat is a patient’s own fat, emulsified and filtered, studied for skin quality rather than for restoring volume [1]. Studies report encouraging results, but the evidence is generally of low quality [2]. In my practice, I use nanofat for selected deep under-eye hollows, because of how delicately I see it settle under the thin skin of the lower eyelid.
- Preparation: emulsified and filtered; no viable fat cells in the original study.
- Evidence: 12 heterogeneous studies in a 2024 review, with no meta-analysis.
- Recent studies: small, short, or combining several preparations.
- My practice: selected under-eye hollows, as a clinical observation.
- Exosomes: a subject I follow, but not something I use in my practice.
- Safety: using your own tissue does not remove the risks.
Nanofat is not the same as the fat grafting used to restore volume, which I explain on my facial fat grafting page. Here, I separate what research has measured, what is still a hypothesis, and what I observe in my practice.
What nanofat is
In the paper that introduced the technique, Tonnard and colleagues emulsified and filtered fat harvested by liposuction. Their analysis found no viable fat cells in the nanofat, but adipose-derived stem cells were still present, with the same capacity to multiply and differentiate in culture as in the other samples [1]. That is why nanofat is not used to restore volume: what has been studied is its effect on skin quality.
Why fat matters beyond volume
Fat tissue has endocrine, paracrine, and autocrine functions and releases signaling substances called adipokines. In a 2020 paper, Marco Aurelio Pellon describes fat grafts as true “secretomes” and discusses their use in acute burns and burn scars (article in Spanish) [3]. It is a plausible mechanism, studied in a different setting; on its own, it does not show that nanofat rejuvenates under-eye hollows.
What the clinical studies show
Tonnard and colleagues used nanofat in 67 cases of fine lines, scars, and dark lower eyelids and described improved skin quality at six months, without a comparison group [1]. In 2024, Tran and colleagues reviewed 12 studies of nanofat used alone: six (253 patients) showed improvement in scars and four described benefits for skin rejuvenation, with increased skin thickness, collagen, and elastic fibers on histology and no serious complications reported. The studies were generally of low quality, and differences between them ruled out a meta-analysis [2].
Two 2026 studies show the limits. Buyukkaya and colleagues compared nanofat with stromal vascular fraction in 20 people, ten in each group: wrinkle scores improved in both, but dermal thickness measured by ultrasound did not change, and assessments ran only to three months, with no untreated group [4]. Sheng and colleagues treated 60 people with lower-eyelid wrinkles using layers of Coleman fat, stromal vascular fraction gel, and nanofat, with improvement at 12 months; because there was no nanofat-only group, the result cannot be attributed to nanofat [5]. Stromal vascular fraction appears here only as the research comparator; it is not a treatment I offer.
Taken together, the research is encouraging but small, short, and heterogeneous. It does not support promising how much the skin will improve or for how long.
How I use nanofat for under-eye hollows
When I assess a lower eyelid, I separate excess skin, under-eye bags, and hollows. In lower blepharoplasty, I remove excess fat from the bags rather than repositioning it, and I use nanofat for deep hollows. I prefer nanofat in this area because of how delicately I see it settle under the thin eyelid skin, compared with microfat. This is an observation from my practice, not a controlled comparison I have published.
When nanofat is added to a facelift and eyelid surgery, the before-and-after photos show the combined result and cannot isolate its effect. That is why I explain at the consultation what each procedure is for and what to expect from it.
Frequently asked questions
Is nanofat the same as an exosome treatment?
No. Talking about cell signaling does not turn a fat preparation into an exosome product. Exosomes are a subject I follow, but I don’t use them in my practice.
Since it is my own tissue, is nanofat risk-free?
No. Harvesting and injecting fat are interventions with limits and possible complications, which I discuss as part of the whole operation.
Can nanofat replace a facelift or eyelid surgery?
No. It works on skin quality, not on sagging tissue or under-eye bags. My deep plane facelift page explains the structural treatment.
Is the improvement permanent?
The available studies cannot say: follow-up is short, and some combine treatments.
Let’s work out what your skin needs
If you have questions about under-eye hollows or about the role of fat grafting in your surgery, write to us on WhatsApp: Bruna, my AI assistant, handles the first contact and then puts you in touch with Isanna to arrange a consultation with me. I’ll explain why I consider each option and what change we are aiming for.
References
- Tonnard P, Verpaele A, Peeters G, et al. Nanofat grafting: basic research and clinical applications. Plast Reconstr Surg. 2013;132:1017–1026.
- Tran VVT, Jin X, Hong KY, Chang H. Effects of Nanofat in Plastic and Reconstructive Surgery: A Systematic Review. Plast Reconstr Surg. 2024;154:451e–464e.
- Pellon MA. Características moleculares y microanatómicas de la grasa y su aplicación en el tratamiento de quemaduras agudas y secuelas. Cir Plást Iberolatinoam. 2020;46(supl 1):53–62.
- Buyukkaya O, Karakol P, Tapki MM, Bozkurt M. Comparison Of Effects Of Stromal Vascular Fraction And Nano-Fat Applications On Skin Quality And Photoaging. Plast Reconstr Surg. 2026 (published online ahead of print).
- Sheng SW, Tu WL, Zhou YL, et al. Combined and Layered Fat Injection for Lower Eyelid Wrinkles: Comparative Efficacy in Mild and Severe Cases. Aesthetic Plast Surg. 2026;50:5328–5336.