Dermal fillers and facial fat transfers are two remarkable non-surgical solutions to eliminate common signs of aging from your complexion. While both treatment options diminish wrinkles and fine lines and restore age-related volume loss, they do so differently. One type of filler might be more effective and beneficial than another, while a fat transfer might be the best option all around. It is important to know the advantages of each solution when deciding which one is right for you. Let Dr. Silvia Rotemberg guide you through this process to restore youthful smoothness to your skin. At her Miami offices, Dr. Rotemberg has helped thousands of patients look and feel their best; she is excited to do the same for you! To schedule a consultation with Dr. Rotemberg, please fill out this online form or give us a call at (305) 539-7083.

Signs of Facial Aging

As we age, our skin’s internal structure starts to lose its tension, causing our skin’s external appearance to wane in youthfulness. To counteract this, beauty experts suggest different creams, serums, supplements, and lotions revitalize our skin’s inner support. But, these typically lead to minimal results. The first step to tackling these signs of aging is to understand what they are and what factors cause them to occur in the first place. 

Wrinkles & Fine Lines

Our skin is kept smooth and tight by tensile collagen and elastin fibers that act as the support scaffolding. When we’re young, these fibers are strong and readily replenished with healthy fibroblast cells. These cells routinely produce fresh fibers to replace the old, keeping our young skin wrinkle-free. However, as we get older, these cells (like all other cells in our body) begin to lose their ability to keep our skin’s fibers refreshed. Over time, the existing collagen and elastin fibers weaken. In fact, by the age of 50, we have approximately lost 30% of our natural collagen supply.[1] While age-related intrinsic factors contribute to collagen loss, other factors like unprotected UV exposure, a non-balanced diet, and stress exacerbate the loss even more.[2] Without cosmetic intervention, our skin soon becomes wrinkled, lax, and mature-looking. 

Volume Loss

Also, with age, different facial features begin to lose their sharp contours. Whether this is our cheeks, chin, or jawline, the angles that make up our countenance slowly lose their definition. This volume loss is because the bones in our face also use collagen and elastin to keep their youthful composition. But, as collagen production tapers off, our bones weaken and regress inwards, causing different areas around our face to appear hollow. This process is called bone resorption. Because estrogen levels speed up bone resorption, volume loss is more prevalent in post-menopausal women.[3] 

How Fillers Restore Volume

To counteract wrinkles and volume loss, Dr. Rotemberg often recommends dermal fillers. Unlike other types of cosmetic injections like Botox and Dysport, dermal fillers are injected into the skin and not the muscle. Because they are injected dermally, they provide a noticeable difference almost immediately. The filler solution restores fibers directly while adding volume to the treated areas. However, what the filler is made of will determine different characteristics. 

Hyaluronic Acid Fillers

Fillers like Juvederm and Restylane use hyaluronic acid to restore volume and bring better moisture to the skin. Hyaluronic acid is a natural chemical found in our bodies. As a hygroscopic molecule, hyaluronic acid can hold up to one thousand times its weight in water, making it valuable for retaining moisture in our skin. In fact, 50% of our body’s hyaluronic acid resides in our skin.[4] Different hyaluronic acid fillers come in different viscosities, making some better for certain areas than others. Patients who receive a hyaluronic acid filler typically see results for up to 2 years.[5]

Poly-L-lactic Acid Filler

Another popular filler is Sculptra. Sculptra uses poly-L-lactic acid to steadily boost the skin’s natural collagen supply. After the injection, the Sculptra serum stimulates the fibroblast cells to increase collagen and elastin production. Unlike hyaluronic acid fillers, poly-L-lactic acid continually boosts collagen supply over time. So, Sculptra patients will see continual improvements in their appearance for months to come. It is perfect for those looking for gradual results for the next two years.

Calcium Hydroxyapatite Filler

Calcium hydroxyapatite, the active ingredient in the filler Radiesse, is a safe chemical that naturally boosts collagen production in our skin. When injected, the Radiesse gel creates noticeable volume. Over the next year, the microspheres in the Radiesse serum stimulate fibroblast cells deep in our dermis. This process provides lasting aesthetic improvement for the next 18 months.[6]

How Facial Fat Transfer Works

A new popular alternative to dermal fillers comes in the form of the patient’s own organic tissue. Unlike dermal fillers, facial fat transfer is a surgical procedure that relocates the patient’s fatty tissue from one part of the body to their face. Wrinkles, fine lines, and volume loss aren’t the only signs we’re getting older. Hard-to-lose, stubborn fat can linger on just about any part of our bodies. By tackling these signs of aging in one simple procedure, Dr. Rotemberg can provide a more all-around cosmetic procedure. She extracts the fat cells via liposuction, purifies and cleanses, and injects it directly into your skin. Because this is the patient’s natural tissue, they don’t have to worry about any adverse reactions or side effects. 

Which One Is Right For Me?

Dr. Rotemberg has helped thousands of patients decide which approach is best for them. When researching each type of filler or facial rejuvenating procedure, it’s important to ask yourself a series of questions.

  • How long do I want my results to last?
  • Do I want to undergo surgical preparation or recovery?
  • Do I wish to see instant results or gradual results?
  • Do I have other cosmetic concerns like unwanted fat that I want to be treated as well?

Dr. Rotemberg and her team will review all of these questions with you during your consultation. Click here to schedule a personal consultation at our Miami offices.

Personal Consultation

Dr. Silvia Rotemberg, the founder of Rotemberg Plastic Surgery, is board-certified and expertly trained in many different cosmetic and aesthetic procedures. She is proud and eager to bring her experience, skills, and knowledge to your one-on-one consultation. We will begin with a brief new patient intake interview and a physical examination. If she decides facial fat transfer is the best procedure for you, we will need to approve you for general surgery. She will examine your wrinkles and volume loss, noting the severity of your skin laxity. Next, if you have any troublesome fatty areas, she will examine and determine if liposuction is the best solution. If she believes fillers to be right for you, she will explain the differences between our collection of fillers. 

Preparation for Fat Transfer

If you are undergoing a facial fat transfer, be sure to follow this list of preparatory steps to ensure an optimal procedure.

  • Avoid smoking a couple of days before surgery and the entire duration of recovery as nicotine constricts blood flow, stifling the body’s natural healing ability.
  • Don’t take any blood-thinning medications like aspirin or ibuprofen as these will cause excessive bleeding during your surgery. 
  • Designate a caregiver to drive you home.


Dr. Rotemberg will wrap the treated area(s) in a compression wrap. This will ensure that no fluid pools around the liposuctioned areas and help the body accept the surgical alterations. The fatty tissue will add noticeable volume right away. Be sure to avoid strenuous activity for the next couple of weeks to allow the body enough time for recovery. We will address any necessary next steps during your follow-up appointment.

Another Facial Rejuvenating Procedures

For those interested in a total facial rejuvenation procedure, Dr. Rotemberg also performs facelifts. By gently lifting the skin and facial structures to a higher resting position, Dr. Rotemberg can eliminate wrinkles, sagging features, and loose skin. To schedule a facelift consultation, please fill out a contact form.

How Much Does Fat Transfer and Fillers Cost in Miami?

Each filler has its price, and a fat transfer comes with the added cost of surgical requirements. We will determine the price of your unique procedure during your consultation. For those interested in financing, visit our financing page or give us a call at (305) 539-7083. If you liked this blog post, be sure to check our others! Dr. Rotemberg is proud to give her clients the most up-to-date information in the industry.


  1. Shuster, S., Black, M. M., & McVitie, E. (1975). The influence of age and sex on skin thickness, skin collagen, and density. The British journal of dermatology, 93(6), 639–643.
  2. Bolke, L., Schlippe, G., Gerß, J., & Voss, W. (2019). A Collagen Supplement Improves Skin Hydration, Elasticity, Roughness, and Density: Results of a Randomized, Placebo-Controlled, Blind Study. Nutrients, 11(10), 2494.
  3. Windhager, S., Mitteroecker, P., Rupić, I., Lauc, T., Polašek, O., & Schaefer, K. (2019). Facial aging trajectories: A common shape pattern in male and female faces is disrupted after menopause. American Journal of Physical Anthropology, 169(4), 678–688.
  4. Ballin, A. C., Cazzaniga, A., & Brandt, F. S. (2013). Long-term efficacy, safety and durability of Juvéderm® XC. Clinical, cosmetic and investigational dermatology, 6, 183–189.
  5. Few, J., Cox, S. E., Paradkar-Mitragotri, D., & Murphy, D. K. (2015). A Multicenter, Single-Blind Randomized, Controlled Study of a Volumizing Hyaluronic Acid Filler for Midface Volume Deficit: Patient-Reported Outcomes at 2 Years. Aesthetic surgery journal, 35(5), 589–599.
  6. de Almeida, A. T., Figueredo, V., da Cunha, A., Casabona, G., Costa de Faria, J. R., Alves, E. V., Sato, M., Branco, A., Guarnieri, C., & Palermo, E. (2019). Consensus Recommendations for the Use of Hyperdiluted Calcium Hydroxyapatite (Radiesse) as a Face and Body Biostimulatory Agent. Plastic and reconstructive surgery. Global open, 7(3), e2160.
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