Silky Fat Injection: Where to have it done? Choose based on fat processing method and injection technique

Silky Fat Injection (a treatment that breaks down your own fat into fine particles and injects it into the face) produces variable results depending on how the fat is processed and how gradually it is injected in each session. When choosing a clinic, it becomes easier to compare by checking the fat handling method, the volume and depth of injection, and experience with the under-eye area.[1][2]. However, how much of the injected fat persists varies from person to person, and results cannot be guaranteed regardless of where the procedure is performed.[3][4].

How does Silky Fat differ from ordinary fat injection?

The difference lies in the fineness of fat particles. When harvested fat is mechanically broken down into fine pieces and filtered, it becomes what is called microfat or nanofat.[5].

Fine fat is reported to be suitable for delicate areas such as hollowness above the eye or the junction from under the eye to the cheek.[1]However, because nanofat has disrupted fat structure, how much persists is difficult to predict, and its ability to add volume is thought to be limited.[3].

Effects on skin texture are still in early stages. In a review of 12 studies using nanofat for scars, improvements over short periods were frequently reported. However, in 2 high-quality comparative trials, clear differences did not persist beyond 12 months.[6].

Where do differences in results come from?

Variation is most likely in the volume injected per session and the injection technique. In a report of 1362 fat injection procedures, a method was used with a blunt-tipped fine cannula, depositing 0.025–0.05 mL with each pass.[1]. The goal of not over-injecting is to reduce irregularity and unpredictable resorption.[1].

Not all of the injected fat persists. In fat grafting, over the long term only about 50% (roughly half) of the injected volume is expected to remain.[4]. For this reason, how many sessions will be needed is another point to discuss beforehand.

Techniques vary by physician. In a survey of American physicians, 54% used a fine cannula to harvest fat, and 47% performed centrifugation (mechanical separation of fat).[2].

What should be watched when injecting under or above the eye?

The eye area is where physician experience shows most clearly. Because skin is thin, even slight irregularities are noticeable. It has been noted that fat nodules visible or palpable are not rare with less experienced physicians.[2].

In a review of fat injection to the eye area, satisfaction in 4046 patients was 90.9%.[7]. Complications occurred in 7.9% (approximately 8 per 100 people), with swelling, scleral swelling, and irregularity most common.[7]. However, most of the studies reviewed are case reports without comparison groups.[7].

How are serious complications prevented?

The most serious complication from fat injection is fat embolism, in which fat enters a blood vessel and causes blockage.[8]. Blindness following injection in the glabella and skin necrosis (tissue damage appearing as blackening) have also been reported.[9].

To prevent this, it is recommended that fat be injected only into the subcutaneous layer (the layer directly beneath the skin) and ideally be confirmed by ultrasound during injection.[8]. Injecting very small amounts per push is also reported as a measure to prevent embolism.[3].

Common issues include nodules from fat necrosis, oil cysts, and calcification.[5]. With nanofat, redness at the injection site persisting 2–3 weeks is frequently reported.[10].

What should you ask when comparing clinics?

When receiving an explanation, asking these 5 questions makes comparison easier.

How the fat is processed (whether centrifugation or filtration is used)[5][2]

How much is injected per session and over how many sessions[1][4]

At what depth and with what type of cannula it is injected, and what measures are taken to avoid blood vessels[8]

Experience with injection around the eye and how irregularity is managed if it occurs[2]

When nodules or redness appear, when and how you can be evaluated[5][10]

What should you check at your consultation?

Where and how much to inject cannot be decided from this article alone. The depth of hollowness, skin thickness, and where fat can be harvested vary from person to person.

At your consultation, confirm with your physician the injection site and volume, the number of sessions planned, and what will be done if complications occur.