This is an ongoing debate among plastic surgeons and dermatologists who perform these procedures. We offer both of these in our office, but in recent years favor hyaluronic acid fillers for facial rejuvenation over fat transfer. Fat transfer is more surgically invasive with a higher risk of complications including infection and scarring. In the past with only collagen fillers available fat transfer to the face may have been superior and longer lasting, but now we have HA fillers like Voluma that last 2 years and stimulate new long-lasting collagen. That being said, sometimes the decision should involve weighing the skill of the physician. Some physicians are more skilled at fat transfer vs. fillers, so despite the lower long term risks of fillers they may get better results with what they are most skilled at.