There are pros and cons to injectable fillers and facial fat transfers. The best procedure for you will depend on your individual concerns and facial anatomy. In general, I prefer facial fat transfers as the patient's own body fat will provide the most natural, voluminous results that are long-lasting and compatible. Injectable fillers do not always provide the best results and because they only last between 4 months to a year and a half, the cost of maintenance adds up. :giggles:
You might try a round of temporary fillers and if you like the effect, you could continue to do these and adjust the areas needed as you age. Avoid permanent fillers at all costs as they have potential uncorrectable complications. Know that fat grafts don't always take and sometimes too much takes so this is not as easy as it sounds.
Also, no filler regimen will give you "the same effect" as a facelift. Just not possible. I have seen people who needed a facelift but tried to get by with fillers and these fell short.
You missed the point of fillers. they are not lifters. they are volumizers. Fat also can be used just about anywhere on the body. Fat is potentially permanent and "stem"cells may be benficial but the science just isn't there yet. The main disadventage of fat is lack of reliability in "take", swelling and length of recovery, potential for asymmetry. General rule if you are having another procedure at the same time, do fat.
Otherwise don't waste 2 weeks of recovery after fat grafting when fillers can do the job with little risk, minimal downtime, and ability to add or subtract (if hyaluronic acid used) from the result as needed.
Finally, I would trust my doctor to help me make an informed decision. It would be nice if they could offer all options so that you don't worry they only offer what they can do. While an in-person consultation would be required, I think that fat transfer to the cheeks, temples, and under the eyes is a great procedure. I think that for broad areas that need volume augmentation, fat is great.
I agree with physicians who have suggested looking at photos of yourself from 10 or 20 years ago, to see how much volume you had to begin with. It is important when answering your question to be evaluated in person. There is a three dimensionality that must be evaluated as well as the condition of the skin and dermis, the roundness of the face, and adjacent areas that may have dropped. If there are focal areas such as smile folds or small indents, then the fillers such as Restylane, Perlane, Juvederm, Radiesse can be used.
Fat injections may involve a series of treatments and not all of the fat lives; it's not that the fat is being rejected, it's just that the some of the cells die before they develop enough circulation in the new neighborhood to live. It is a thicker product then some ready-to-use fillers. The fillers don't have a rejection possibility, they continue to dissolve after the first day they're placed but their longevity is different in different situations.