Lots of patients inquire about the use of fat vs fillers (Restylane, Juvederm,Radiesse etc) for youthful enhancement. Often the answers they receive reflect the biases and experiences of the injector. Simply summarized, here are the pros and cons of each: Fat is your own tissue, its often available in quantity (unfortunately!) and is very versatile in many areas of the face (lip, brow, cheek fold etc). The downside is that it requires a surgery to harvest with all its inherent risks and recovery. Fillers are readily available without a procedure, offer uniformity of manufacture and composition and can be received in a simple office visit. The downside is that no one filler is great for all areas, and the length of time they last before needing to be repeated varies. Here are some pearls for the “educated consumer”. Success with injectables whether fat or filler is highly dependent on the skill of the injector. Who’s doing it (doctor, nurse, aesthetician)? How often do they do it, what’s their background (surgeon, dermatology, ob/gyn, fam practice)? etc. Don’t be afraid to ask! One argument I often hear is that fat lasts longer and is sometimes permanent compared to fillers. Whenever I hear this I always think of the child’s riddle of what weighs more, a pound of feathers or a pound of iron. Most injectable treatments use prefilled syringes containing 1-1.5 cc of material, with patients receiving anywhere from 1-4 syringes. I’ve seen many demonstrations of fat injections where the doctor injected 40 0r 50cc’s of fat or even up to 80 or 90 cc’s! If you put that much Juvederm or other filler in someone’s face they’d make Peanut’s Charlie Brown look anorexic! So while some of it may last a long time, most of it is gone pretty fast. One last pearl about permanence with any filler-they are kind of like tattoos, you’d better love the result in your face because if it’s a permanent (silicone?) injection it’s going to be there for you (and others) to look at for a long time.