# How I Prepare Fat for Facial Grafting

From harvesting to injection: why I wash and centrifuge fat, how processing follows the treatment goal and what it cannot guarantee.

[Dr. Walter Zamarian Jr.](https://www.walterzamarianjr.com/us/walter-zamarian/) · CRM-PR 17.388 · RQE 15.688
Published November 14, 2026

Topics: [Facial fat grafting](https://www.walterzamarianjr.com/us/blog/category/facial-fat-grafting/)

[Read the article ↓](#leitura)

## At a glance: how I prepare fat for facial grafting

I harvest fat through liposuction, usually from the lower abdomen or inner thigh. I then wash it to remove blood and centrifuge it to remove excess fluid left from washing. Processing involves successive reductions: millifat, microfat and, when the treatment goal calls for it, nanofat. I use microfat to add volume and nanofat to address skin quality. These steps do not guarantee that all the transferred fat will remain.

- Harvesting: the patient’s own fat is taken from a donor area.

- Washing and centrifugation: separate steps that remove different components of the harvested material.

- Processing: millifat is the first reduction; in the face, I use microfat and nanofat for different purposes.

- Results: some initial volume is lost; integrated fat can last long term, but the time it takes to stabilize varies.

My [facial fat grafting](https://www.walterzamarianjr.com/us/face/fat-grafting/) page covers who may benefit and the general care involved. Here, I explain what happens between harvesting the fat and placing it in the face. Understanding that process helps you distinguish prepared fat from the fluid collected along with it. This is an explanation of my practice, rather than instructions for performing the procedure.

## Where the fat comes from

I usually take fat from the lower abdomen or inner thigh for use in the face. Whether I recommend grafting depends on the facial assessment and the goal for each area, even when there is fat available elsewhere on the body.

Gornitsky and colleagues found a range of donor sites in their review of facial fat grafting [1]. They did not identify one site as best for everyone. My usual donor sites reflect my practice, without guaranteeing how much fat will survive.

## Why I wash the fat

Liposuction collects fat mixed with fluid, blood and material that may be released during harvesting. Separating these components is part of graft preparation described in the literature [2][3].

When washing the fat, I aim to remove as much blood as possible and reduce material that accompanies the fat without providing lasting volume. The volume in the container just after harvesting is therefore different from the amount of fat that may remain in the face.

That is the purpose of washing. It does not establish better integration, freedom from inflammation or a predictable retention rate for an individual patient. Studies use different techniques and different ways to measure outcomes [1][2].

## What centrifugation does after washing

After washing, I centrifuge the fat to remove excess fluid. Centrifugation separates components of different densities without adding tissue to the harvested material [2].

Even after fluid is removed, lasting volume depends on the fat integrating into the recipient tissue. The cited reviews do not show that one processing method is superior in every setting [1][3], and the equipment used cannot predict how much volume will remain.

## Millifat, microfat and nanofat

The first reduction step produces millifat; the second, microfat; and a third, when indicated, nanofat. In the face, I use microfat and nanofat, each with its own role. Further processing does not make a preparation better suited to every purpose.

An area with a hollow and fine wrinkles may need both preparations. Since nanofat does not replace a volume-restoring graft, some of the fat may be left as microfat rather than processed further.

One uncontrolled study of nanofat combined with platelet-rich plasma assessed skin changes; predicting the benefit and how long it lasts remains difficult [4]. I explain how I choose a preparation for each area in [microfat and nanofat: different goals for the face](https://www.walterzamarianjr.com/us/blog/microfat-nanofat-different-goals-face/).

## Care during injection matters too

I inject with a blunt microcannula, using small amounts and low pressure to avoid large deposits in one spot. Reviews discuss small deposits to increase contact between the graft and surrounding tissue, and pressure control as a precaution intended to reduce risk [2][3].

Risks remain even when using your own fat: asymmetry, contour irregularities, nodules, infection and loss of part of the graft. Fat inadvertently entering a blood vessel can cause severe complications, including vision loss and stroke [3]. Preparation and injection precautions do not eliminate these risks.

## What changes during recovery

During recovery, swelling subsides and some graft volume is lost [3]. An early photograph reflects both effects; it cannot measure fat integration or predict the final contour.

Integrated fat can last long term, but stabilization varies by person and facial area. There is no fixed point when every patient’s result is final. Differences in follow-up and measurement also limit how well study averages can predict your result [1].

## Frequently asked questions

Are washing and centrifugation the same step?

No. In my practice, washing removes blood, while the centrifugation that follows removes excess fluid left from washing. They are separate parts of preparation, not guarantees of complete retention.

Is all harvested fat turned into nanofat?

No. Processing depends on the goal. I use microfat for volume and nanofat for skin quality. Further processing into nanofat does not make it a substitute for a volume-restoring graft.

Will the fat that remains last forever?

Integrated fat can last long term, but retention and stabilization vary [1]. That is not a promise of lifelong persistence in an individual patient or a face that will never change.

Do small amounts and low pressure eliminate risk?

No. They are technical precautions, but they do not eliminate complications, including vascular complications [3]. Assessing whether treatment is appropriate and discussing its risks remain necessary.

## What to clarify before deciding

At the consultation, I explain each proposed treatment area and the reason for it: volume, skin quality or both. You can ask why an area would receive fat and what change we hope to achieve there. I also respect a decision not to graft a particular area. To discuss your case, [write to us on WhatsApp](https://www.walterzamarianjr.com/us/contact/): Bruna, my AI assistant, handles the first contact and then puts you in touch with Isanna to arrange a consultation with me.

## References

- Gornitsky J, Viezel-Mathieu A, Alnaif N, Azzi AJ, Gilardino MS. [A systematic review of the effectiveness and complications of fat grafting in the facial region](https://pmc.ncbi.nlm.nih.gov/articles/PMC7061561/). JPRAS Open. 2019;19:87–97.

- Shauly O, Gould DJ, Ghavami A. [Fat Grafting: Basic Science, Techniques, and Patient Management](https://pmc.ncbi.nlm.nih.gov/articles/PMC8932485/). Plast Reconstr Surg Glob Open. 2022;10(3):e3987.

- Brown K, McCoskey M, Nakra T. [Complications of facial autologous fat grafting](https://www.oaepublish.com/articles/2347-9264.2023.94). Plast Aesthet Res. 2024;11:7.

- Menkes S, Luca M, Soldati G, Polla L. [Subcutaneous Injections of Nanofat Adipose-derived Stem Cell Grafting in Facial Rejuvenation](https://pmc.ncbi.nlm.nih.gov/articles/PMC7015601/). Plast Reconstr Surg Glob Open. 2020;8(1):e2550.

## About the author

I am Dr. Walter Zamarian Jr., a plastic surgeon in Londrina, Brazil. My practice focuses on deep plane facelift surgery with fat grafting. Here I explain my approach, the available evidence, and the limits of each treatment.

CRM-PR 17.388 · RQE 15.688

[Read about my training and practice →](https://www.walterzamarianjr.com/us/walter-zamarian/)

This article provides general information and does not replace an individual medical consultation.

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