Fat grafting or fat transfer to the face was introduced and popularized by New York plastic surgeon Dr. Sydney Coleman, who had begun by using fat to correct deformities in the lower body. Over the past decade more refined cannulas were produced to aid in meticulous fat transfer to areas such as the lower eyelids, and the technique has achieved widespread acceptance. Fat grafting to the face can produce permanent, natural results. Dr. Roy David has been performing fat transfer in San Diego for over ten years, with consistently excellent outcomes.
WHY FAT TRANSFER?
As we age, we lose volume in the face. This leads to sagging, deflated skin, and concave sunken areas. Some common areas for fat loss include the cheeks, temples, lower eyelid “hollows,” jawline, lips, smile lines and premaxilla. For years these areas have been treated with synthetic injectable fillers-and continue to be with great success. The problem with these fillers is that they are not permanent (with few exceptions) and must be repeated at intervals leading to occasional swelling and bruising. Furthermore, these fillers are not our own natural tissue; we believe that injecting one’s own fat enhances the skin and facial contours by increasing blood supply and overall skin health.
Fat grafting is performed with blunt micro-cannulas. This makes the procedure very safe, as well as artistic and nuanced; the surgeon is able to “sculpt” the face in a natural way by gradually adding volume in diffuse increments. This is a different approach from most synthetic fillers- which are often placed in discrete aliquots.
One simple guideline for deciding between fat transfer or synthetic fillers is as follows: If you are planning a facial procedure under anesthesia and will be in the supine position, it is generally easy to add fat grafting. In this case, the procedure is cost-effective and gives permanent results.
Fat transfer is commonly performed at the same time as facelift surgery. We now know that simply tightening and lifting sagging skin and soft tissue does not produce the best and most natural results. It is important to simultaneously correct areas of hollowness and fat loss, so that the lifted skin appears well supported and obtains a youthful contour. We believe fat transfer can dramatically improve the results of even the best-performed facelift, as well as increase the longevity of facelift results. In the patients below, fat transfer was performed in the lower eyelids, cheeks, and jawline to enhance their mini facelift results:
Many of our patients choose to have fat transfer during eyelid lift surgery for enhancing the lid-cheek junction as well as the brow region. In the patient below, notice the increased volume of his upper cheek and how it now blends with his eyelids for a natural, youthful look. This cannot be done with a conventional eye lift alone:
Rhinoplasty patients who are under general anesthesia often request fat transfer to enhance the lower eyelid hollows or naso-jugal grooves. Because the eyes and nose are adjacent structures, these procedures complement each other in a very positive way:
Younger adults often seek fat transfer to correct congenital hollowness in the eyelid or cheek regions. In such cases, it is performed with mild sedation in our private operating suite, and patients are able to go home shortly afterward. Similarly, fat transfer may be combined with a laser peel to give dramatic lifting and tightening of facial tissues that can surpass the results of a mini facelift in some cases:
THE FAT TRANSFER PROCEDURE
Fat transfer in our San Diego practice is generally performed with a gentle “twilight” anesthesia in our AAAHC accredited surgical suite. Patients may also choose local anesthesia with oral sedation for this minimally invasive procedure. Following administration of tumescent anesthesia to the fat harvest site, the fat is gently harvested using micro cannulas. The fat is processed to remove impurities, and then carefully injected into the areas of concern. There is minimal to no pain after fat grafting, and a majority of swelling resolves within one week, allowing a return to activities.
Any cosmetic procedure will have some risk, and common risks with fat transfer include swelling, bruising, and inadequate correction. Lumpiness of transferred fat is also a possibility, however this is minimized with proper technique and use of micro cannulas. Rare nodules may be treated with cortisone or excised. Patients should be aware that transferred fat can be expected to behave as it would in its original location, and unanticipated weight gain or weight loss may be reflected in the transferred fat.
A majority of transplanted fat is expected to survive and become permanent, effectively increasing the volume of the cheeks, lips, temples and remainder of areas affected by aging and fat loss. The key to successful fat transfer is the use of specially designed micro cannulas, which transfer small parcels of fat that are more likely to survive. The harvested fat must also be carefully cleansed prior to injection. Fat transfer is always accompanied by some degree of swelling, however within one week appearance is generally quite pleasing. Complete resolution of swelling may take four to six weeks, however this process is gradual and generally not noticeable to others. There can be some fluctuation of fat volume in ensuing months, as the viable fat revascularizes. At six months, retained facial volume is considered permanent.
For Fat Transfer in San Diego, California, contact our office at 858.658.0595. We look forward to meeting you!