At a glance: microfat and nanofat have different goals
I use microfat when the aim is to add facial volume and nanofat when the aim is to address skin quality. Both may belong in the same treatment plan, even in the same area, if there are separate needs. The choice depends on your concerns and the examination: a hollow, a fine wrinkle and sagging tissue are different problems. Neither preparation guarantees a particular result.
- Volume: microfat for areas where added volume is appropriate.
- Skin: nanofat for skin quality goals, with a variable response.
- Combining them: only when there is a reason for both in that area.
- Your decision: you do not need to choose a technique before your consultation.
In facial fat grafting, I prepare your own fat according to what I intend to treat in each area. Here I explain how we discuss that choice at the consultation. For the mechanisms and studies, see nanofat and skin quality: what the research can tell you.
Start with the change you want
Hollow temples, lines around the mouth and sagging tissue need different assessments. Before choosing microfat or nanofat, we need to identify which change concerns you.
At the consultation, I explain where I recommend grafting and why. Examples include a hollow forehead or temples, under-eye areas that need volume, and pronounced nasolabial or marionette folds. In each area, I consider the examination findings alongside what you want to change.
You might say, for example, “I want this hollow softened, but I don’t want fuller cheeks.” That helps define the limits of the plan. You can simply describe your concern; we will discuss the diagnosis and choice of preparation at the consultation.
When the goal is volume
With microfat, I aim to restore volume where the examination shows a deficit, taking the proportions of the face into account. Studies report variable retention: some of the injected volume may be lost [1].
At the temples, I assess whether lost volume needs replacing. A cheek that already has enough volume can be left ungrafted even when another area is treated.
If you worry about looking too full, we discuss that before surgery. I show selected before-and-after cases to explain the proposal and talk through expectations. These examples cannot guarantee your outcome or rule out overfilling, asymmetry or contour irregularities [2].
When the goal is skin quality
I use nanofat to address skin quality under the eyes, in fine vertical lines around the mouth and, in selected cases, in fine wrinkles over the cheeks and cheekbones. Filling a hollow calls for a preparation intended to restore volume.
When discussing skin quality, we need to name the concern: texture, fine lines or the appearance of that area. “Rejuvenation” is too broad a term to describe what we hope to treat.
Research on skin benefits still has important limitations. Menkes and colleagues followed 50 people treated with nanofat combined with platelet-rich plasma, without a control group [3]. That makes it difficult to attribute the results to nanofat alone. The improvement and duration observed cannot predict your outcome, and the study protocol does not necessarily reflect my technique.
Under-eye area and lip lines: two questions for each area
Under the eyes, I explain volume replacement separately from using nanofat for skin quality. We need to work out what is causing the concern there: “under-eye circles” does not define the treatment, and fat cannot address every change in that area.
For fine vertical lines around the mouth, I use nanofat to address skin quality. If volume is also needed, I use microfat. I may recommend both in the same area, each for a specific purpose.
Tell me if you are worried about added fullness when texture is your concern. If there is a hollow, ask how it would be treated and what would remain without volume replacement. The assessment considers your face, not just an enlarged image of one wrinkle.
What if the concern is sagging?
A facelift repositions tissue. Fat grafting may be added when volume or skin quality also needs attention; combining the procedures is optional.
When recommending grafting with a facelift, I explain the reason for treating each area. If you decline grafting in one area, I respect that decision. The plan needs both a medical indication and your consent; a preference does not justify an unsuitable procedure.
If someone chooses a facelift without grafting despite needing volume, I explain that they may want hyaluronic acid filler later. Any touch-up depends on an assessment; I do not assume repeat injections will be necessary or ask for a permanent choice between fat and filler.
Assessing progress without mixing up the goals
As swelling subsides and some grafted fat is lost, the visible volume changes. Integrated fat can last long term, but stabilization varies [1]; the early appearance does not measure final integration.
In my practice, I have seen skin improvement begin at one to two months and continue over the following months. That observation is not a guaranteed timeline. How long a skin change lasts needs to be assessed separately from how long the added volume remains.
To compare photographs, we need to know which procedures were performed and when the pictures were taken during recovery. A result after combined surgery cannot isolate the contribution of each procedure.
Risks belong in the decision too
Harvesting and injection carry risks even when using your own fat. Prolonged swelling, irregularities, nodules, infection and undercorrection or overcorrection can occur. Serious vascular complications of facial fat grafting, including vision loss and stroke, have been reported [2]. These risks need consideration even when the desired change is small.
Frequently asked questions
Is nanofat better than microfat?
There is no such ranking. I use microfat for volume and nanofat for skin quality. The preparation should match the goal, rather than the idea that one name represents an upgraded version.
Do I need both throughout my face?
No. Each area needs its own indication. A plan may include both, one or neither. Having fat grafted in one area does not mean the others need treatment.
Can I decide against grafting in a particular area?
Yes. I explain the proposal and respect a decision to decline. We should also discuss what that choice may leave untreated and what alternatives might be considered.
If I need more volume later, is another fat graft my only option?
Not necessarily. I selectively use hyaluronic acid filler to supplement volume under the eyes when appropriate. The decision depends on an assessment; it is not a required step or an automatic correction of every early difference.
Bring your goals to the consultation
For an explanation of processing, read how I prepare fat for facial grafting. To discuss your face, 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. You can start with three things: what you want to change, what you want to preserve and which questions you still need answered before deciding.
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. JPRAS Open. 2019;19:87–97.
- Brown K, McCoskey M, Nakra T. Complications of facial autologous fat grafting. 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. Plast Reconstr Surg Glob Open. 2020;8(1):e2550.