Laser resurfacing vs Regenerative fat grafting

Modified on | by Dr. Ricardo L. Rodriguez

As we age, our dermis thins, facial skin loosens, and wrinkles develop.  There are several alternatives to treat the aging face. If a patient is not interested in a face lift, but wants a long lasting result, the two alternatives are:

  1. laser resurfacing
  2. regenerative fat grafts

What is the difference between these two techniques?

A LOT!  In summary, Laser resurfacing technologies destroy tissue (which the body repairs), while fat grafting (Fat injections) builds up and regenerates tissues.

Most lasers shoot a high energy beam which vaporizes cells, whereas fat grafting techniques mobilize teams of repair cells to bring more blood supply and nutrients to your face.

I believe that stem cell enhanced fat grafting offers an advantage to lasers currently being used by plastic surgeons and dermatologists. Fat grafts are the most natural way to get a long lasting youthful rejuvenation of your face. Fat grafting is your own fountain of youth.

How do lasers work to tighten the skin?

With laser, a beam of energy is used to obliterate layers in the epidermis and dermis beneath your skin. The cells in those layers are totally vaporized. Once that layer has been destroyed the body sends a signal to repair. Your body repairs the tissue by forming a scar (or “building collagen”) in the destroyed tissue layer.

The scar which forms beneath the skin has the effect of tightening the skin and and adding a little mass to the subcutaneous tissues. However, this does come at the expense of scar tissue and reduction of the dermal layer which gives structure to the skin.

Another problem with laser occurs when a patient loses weight following laser resurfacing treatment. I have seen some patients have a collapse of the structure of the dermis in the face. As the patients loses her own fat, which provided structural support, the laser treated skin sometimes does not hold up well.

Fortunately, I have been able to offer these patients fat grafting, which restructures the dermis and adds volume back to the face.

How does Fat grafting work?

Fat grafting harnesses the power of stem cells that occur naturally in your own fat.  These naturally occurring fat stem cells are carefully extracted by liposuction from unwanted areas, processed with minimal manipulation, and then reinjected during the same operative session into areas that need rejuvenation.

So what is Fat grafting and why is it considered a regenerative technique?

The naturally stem cell enriched fat restores volume and youthful fullness to your face. The naturally occurring ADSC’s in your own adipose fat tissue make new blood vessels. These new blood vessels bring blood supply and nourishment to your aging skin.

Fat grafting is a natural way to restore volume and a youthful glow to the aging face. I use fat grafting as a standalone procedure and also in combination with the face lift procedure.

An added bonus with fat grafting is that the skin continues to improve months  after the surgery. The newly created blood vessels in the fat graft continue to re-energize the tissue with a new source of nutrients.

(originally published 2/23/2010)

By Dr. Ricardo L. Rodriguez MD Board Certified Plastic Surgeon Cosmeticsurg Baltimore, Maryland Ricardo L. Rodriguez on American Society of Plastic Surgeons.

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17 thoughts on “Laser resurfacing vs Regenerative fat grafting”

  • Josefina Carrillo says:

    Hola Dr. Tengo una hija de 15 años, le hicieron 5 tratamientos PDT para su acné, después de un mes de su último tratamiento l, estoy con horror viendo cambios en su carita. Arrugas en su frente, sus ojeras más pronunciadas, pareciera que envejeció en el último mes. El Dr. dice que solo está en mi mente pero yo lo puedo ver. Será posible que está perdiendo volumen por el IPL que le hacían con el tratamiento? De antemano gracias

    • Dr. Ricardo L. Rodriguez says:

      Perdone que haya demorado tanto en la respuesta, pero claramente su hija necesita injertos de grasa para restaurar el volumen. Usted ha captado bien la situación. Si todavia le interesa, me puede consultar llamando al 410 494-8100

  • Shumaila says:

    Hi, I had an accident on 30th June 2015 and got laceration on forehead and under the eye till nose (two horizontal) lines and a bend in my right side of the nose because I was wearing glasses. I had Sacar treatment for complete one year by applying silicon gel sheet. Now my plastic surgeon advice for fat grafting for reshaping nose and filling the lines on forehead and under eye area. Also my aesthetic (dermatologist) advice for fractional laser. Now I want to know wheather I can do these two procedures simaltaneously or which one I should get first and how long I have to wait for the other procedure to be done.

    • Dr. Ricardo L Rodriguez says:

      Shumalia: I would get the Laser first because it is an "injury". Then inject the fat. The rationale is that the stem cells in the fact are most active when reacting to an acute injury. Don't wait too long, do it a day or two after the Fraxel.

    • Dr. Ricardo L Rodriguez says:

      Linda: This is not a matter of age, but of anatomy. For example, the youngest patient I have done was in her very early twenties. Although people tend to lose fat under the eyes as they age, some individuals have shallow cheekbones and fat injections under the eyes do wonders in these cases. Check out our gallery page. If you're thinking about it and have noticed, you probably could benefit from it. Contact Kelly at kelly@cosmeticsurg.net, she'll be happy to help!

  • DCNGA says:

    Thank you for admitting to the 'possibility' that lasers can cause facial fat loss. Please feel free to visit the website above or the support forum of over 200 people experiencing fat loss and textural changes from laser/light devices. You're correct, there are no 'scientific' studies to back up these claims of texture changes and fat loss. Who is going to do the studies? Would it be the top laser 'gurus' who receive remuneration from the laser industry or have vested interests in the making sure the lasers are presented as safe with minimal side-effects or the laser industry who would NEVER admit any of these issues lest their bottom line is affected? I've written to the foremost experts in the world on fat atrophy and lasers, none will help. Why? I have no clue. These devices receive FDA approval through the flawed 501(k) process that does not require clinical trials on any of these devices, especially none by third party, disinterested entities. I guess my question to you would be why, if in theory you think facial fat loss is possible from laser, would you continue to perform it in your practice? I'm not condemning, just trying to figure out the logic. Please, visit and read the stories of those harmed: http://iplandlaserdamagesupport.prophpbb.com/forum14.html Thank you for reading and if this makes it to your blog, KUDOS!

    • Dr. Ricardo L Rodriguez says:

      To whom it may concern at DCNGA: I seldom let any post through that has somebody's website on it, as it is usually just a way to get traffic to their sites. The sites in question are usually competitors or totally unrelated. Your post; however, merits attention, and I encourage readers of my blog to go there. There is enough meaningless cheerleader content being disseminated, but surgery has its risks, and people need to know about it. As to why there is no research, I also do not know. I can tell you it was a rare thing for me, having done so many Lasers. Still, once was enough. The full resurfacing laser is more risky, and I do think Fraxal is less risky, although judging from your site, not risk free. I have veered away from Lasers, dedicating myself to fat grafting. It is a constructive approach, using your own stem cells, unlike the Laser which destroys, then your body heals. There are risks to fat grafting, but proper technique really lowers the risks close to 0. The key is proper handling of the fat cells.

  • Elle says:

    The weight loss following laser that you mention is not normal weight loss but lipoatrophy caused by the laser. The same type of fat loss that some HIV medications cause as a side effect. It ages the skin in a short time. Thank you for this post! Very informative.

    • Dr. Ricardo L Rodriguez says:

      Elle: Subcutaneous fat loss can be caused by many things, amongst them hormonal changes, ageing, etc. I do suspect the lipoatrophy can be caused by the Laser, but I have not heard of any experimental data to back this up. If you know of any studies, I'd love to know about it. In any case, why go with a destructive technique (laser) when you can go with the body's own regenerative powers? Thanks for your feedback!

  • Springfield Abdominoplasty says:

    Thanks for sharing the video and speaking about the differences between Laser and Grafting.

    • Dr. Ricardo L Rodriguez says:

      Dr. Wright: It is a pleasure to hear that other Plastic Surgeons read my blog. BTW you curriculum vitae is super solid and I commend you for it. I wish you all the success in the world!

  • Bridget says:

    Thank you so much! I sounds much better than I was thinking as far as the recovery. I will be in touch. Sincerley, Bridget

  • Bridget says:

    Hi Dr. This procedure sounds great. I am very interested and I have been reading so much about it. I am confussed though about the recovery time? I am an avid walker/runner which I do for about 1 1/2 hours 4 days per week. I hear it is very important not to raise your BP or HR. for several weeks! (That seems like a lot to ask of someone who works out with any consistancy) I realize you need to follow the rules though.... What do you recommend for success after fat injections to cheeks and nasal folds?

    • Dr. Ricardo L Rodriguez says:

      Bridget: The procedure IS great! As far as the recovery time, I don't think you have to worry about "not to raise your BP or HR". Just keep your head above the level of the heart for the first week or as to allow for drainage. For the first 7-10 days, you will be very swollen. Most patients tell me they look like a chipmunk. But relax, the swelling will go down and by the third week you will be back to normal. As far as working out, you will be fine to do so by postoperative day 7 to 10. Call Kelly at kelly@cosmeticsurg.net for more info. Go for it!

  • Joan Levanios says:

    Hi, I am very intersted in this new procedure. Is the legal in USA? I read about Fat Grafts & Stem Cells before, how long does this treament last on the 'face'? What are the possible risks? Without having general anesthesia, what is the cost to have this procedure done on the face? Thanking you in advance, Joan

    • Dr. Ricardo L Rodriguez says:

      Joan: This procedure is entirely legal. The stem cells are your own. The treatment, when well done, lasts for a lifetime. Although a lot of patients have this done under IV sedation, quite a number do it under local anesthesia. The most important thing aboutr the stem cells is that they truly rejuvenate your skin, new cells are generated by the stem cells. Contact Kelly at kelly@cosmeticsurg.net, she'll give you details. We'd love to hear from you!