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Massive fat loss?  I say fat.  It's more cost effective, and whatever survives is likely permanent.  Sculptra is also used for significant volume loss, but it's not permanent (even though it can last years in people).

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Fat .... the good specialist will tell you that two treatments are needed. Why? Because of unpredictably of fat re-absorbtion by your body. If you are talking averages, 30 percent ... good specialist NEVER over correct  incase you fall in the 100 percent retention. Hence, good honest guys will tell it like it is, count on 2 sessions but if you are fortunate, only one. Also good guys will finesse with fillers, use fat as the 'land fill' then finesse with what ever they are comfortable with- Bellafill (erkkkkkkkk), HA (safe), Sculptra, or hyper dilute Radiesse or even PRP. Many roads to the same destination. Just don't over fill with fat, and count on the predictability of unpredictability. Realistic expectations and you will not be disappointed. Finesse is the key to getting the end point everyone desires, and fat (even in the best of hands) is unlikely to achieve that. That is my limited knowledge of this situation... Wish you well. 

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