If the Inuit are said to have 50 words for snow, then there are just about as many words and phrases for the pursuit of youth in beauty: Anti-aging, dewy, glowy, tight, bouncy, smoothing, firming, volume, lifting, filling, collagen, anti-wrinkle, texturizing, poreless, softening, rejuvenating, elasticity. But lately, a somewhat surprising word has reemerged: Fat.
There have been some clues that a certain type of soft fullness, especially in the face, is having a moment. Blush was the top-selling beauty product of 2024 on Amazon, all the better to achieve plump, rosy cheeks like Sabrina Carpenter’s. A popular blush stick from Westman Atelier is named Baby Cheeks, and Hailey Bieber declared “baby cheek flush” to be last summer’s biggest trend. “We used to just chase away wrinkles,” says New York plastic surgeon Lara Devgan, MD. “Now we understand that youth is in the fullness of the face.”
The pursuit of a baby face goes beyond makeup: Fat grafting procedures are up 50 percent, according to a 2024 member survey from the American Academy of Facial Plastic and Reconstructive Surgery. As the name suggests, this is a surgical procedure in which fat is taken via liposuction from one place (called the donor site), such as the inner thighs or abdomen, and then injected someplace else, such as the breasts, cheeks, temples, under the eyes, or in creases around the nose and corners of the mouth, explains Babak Azizzadeh, MD, a facial plastic surgeon in Los Angeles. As we become older, the skin on our faces and bodies loses volume and becomes flatter and thinner, due to a reduction in bone density, muscle, and fat. Losing weight rapidly (such as with GLP-1 drugs) can also show up in the face. Doctors use fat grafting to increase the volume that’s been lost. “It’s probably one of the biggest trends that I’ve seen in a long time. I love fat,” Azizzadeh says, with a little bit of glee in his voice. Devgan calls it “nature’s filler,” a term that makes fat sound positively idyllic. “It’s the ultimate sustainable filler,” she says. “It’s your own cells repurposed to rejuvenate, rather than just reshape.”
Typically, doctors use fat grafting as an add-on procedure when a patient is undergoing a facelift. Devgan describes it as being like the “frosting on a cake,” while St. Louis facial plastic surgeon L. Mike Nayak, MD, equates it to “French fries”—an accompaniment rather than an entrée. “It’s a great tool in the toolbox, but it’s an adjunctive procedure that is used when it’s necessary,” agrees Sean Alemi, MD, a facial plastic surgeon in Great Neck, New York, and Darren Smith, MD, a plastic surgeon in New York adds, “For the right patient.” But just like a high schooler eating lunch, some are fine with a side dish being a full meal. A treatment called the “boomerang lift” is a term for a type of rejuvenation achieved only with fat grafting. And an increasing number of people are documenting the results of their fat grafting procedures (no facelift required) on social media. (Southern Charm reality TV star Molly O’Connell shared on the show how fat from her ankles and calves was used for her new breast augmentation.)
The current popularity of fat grafting can be partially attributed to the fear of filler overkill. Fat is already a component of your face and body, so it looks more natural. “Fat is different—it’s living tissue, it’s opaque, it’s flesh-colored. It doesn’t swell and unswell the way those starch jellies [from fillers] do,” Nayak says. It works well in places where filler often looks obvious, such as under the eyes.
Much as with filler, there are multiple options for particular cosmetic needs—macrofat, microfat, and nanofat—each of which serves a different purpose. Nayak tells me to envision macrofat as a cluster of grapes: “Since there is a lot of structure there, you can truly create meaningful volume. It really changes the arcs of the face,” he says. Microfat is more like individual grapes, and can be used to treat lines, while nanofat is more like grape juice—it won’t add volume, but it does contain cellular messengers, stem cells, and growth factors that may rejuvenate the skin (an effect that he says is similar to plasma injections). “It’s one of the best actives,” he says.
Still, unlike filler—which is minimally invasive and mostly reversible—fat grafting surgery is permanent and can have unpredictable results. Some doctors believe that fat cells can continue to grow after grafting, in response to hormonal changes. Fat cells do not forget where they came from, a phenomenon doctors call “donor dominance.” Alemi tells me to think about it like citizenship: If a fat cell is a citizen of Thigh Country and gets transplanted to Face Land, it will continue to behave and flourish like it’s still in the thighs, which may not be ideal for people who gain weight more easily in that area. Devgan believes that the risk of unexpected results is lessened when smaller volumes of fat are transplanted. But because of this risk, fat grafting might be a better option for a patient who is postmenopausal, or at the least, Devgan says, “a patient in her 40s or above who is not likely to go through major weight fluctuations.” Filler may also be a better choice for certain areas that require more precise detailing, such as the jawline, and it treats some fine lines better than microfat. Fat grafting also isn’t the most efficient, as not all fat cells survive when they are moved to a new site, so doctors have to account for a certain amount of attrition.
As you can only transplant your own fat, there is a small category of people who don’t have enough fat to graft. But a newish FDA-approved filler called Renuva could be a solution for such patients, as it is a regenerative injectable that may help stimulate fat growth. (Silicon Valley biohacker Bryan Johnson recently detailed his own journey to a younger-looking face with Renuva in a YouTube video called Project Babyface. Spoiler alert: He had an allergic reaction to the product, and his face swelled up like a balloon.)
After the surge in buccal fat removal surgeries a few years ago, it can feel like a crazy (and somewhat bitter) pendulum swing to think about now adding fat back into the face. When I bring this up, Devgan laughs: “I know the clickbait is: ‘Make faces skinny, now make them chubby,’ but it’s really not like that.” She clarifies that a surgeon wouldn’t graft fat onto the place where they just took out buccal fat. “A beautiful face has topography, with highlights and lowlights. You want fullness in the upper face, at the apple of the cheek, and slimness in the lower face,” she says. I’ve long since embraced the chubby cheeks that my grandma used to pinch, but it’s nice to know that they are keeping me looking youthful, too.
A version of this story appears in the May 2025 issue of ELLE.
