Facial Fat Grafting
From the thighs to the cheeks, fat is the new ‘natural’ facial filler of choice. Dr. Walter Tom explains how surgeons today use your unwanted fat to restore a youthful face.
Submitted by: Walter W. Tom, MD, FACS: Aesthetic Laser & Vein Centers
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In the past, patients have undergone facelifts that primarily consisted of pulling the skin up and outward, cutting away the “excess” skin, and suturing it in place. Today, we’re smarter, and a new paradigm of facial aging has emerged: We know that our faces lose volume (fat) as we age. So like a deflating beach ball, we develop loose skin that drapes over our facial bone structure. If you look at an old photograph, you’ll notice that usually our bodies are slimmer and our faces are full, with more prominent cheeks. The key to re-establishing a natural, more youthful look?
To replace lost volume using a 3-dimensional approach—a welcome piece of knowledge for patients today who fear that traditional wind-blown lift and “skeletal” appearance, and also desire less invasive procedures that do not require a prolonged recovery and general anesthesia.
What’s liposuction have to do with it? Fat has become the new wonder treatment for cosmetic rejuvenation, including the face. Our fat tissues contain not only fat cells but also our own inherent stem cells. In fact, there are as many stem cells in our fat tissues as we have in our bone marrow. When harvested via liposuction, “live” fat cells are transplanted to a new location where there is a restoration of lost volume and ultimately an improvement in the quality of the skin too.
The Facial Fat Transfer Technique
Facial fat grafting is an in-office procedure, usually under local tumescent anesthesia with oral sedation. First, we harvest fat through gentle liposuction with small micro-cannula, and the fat is collected in a closed sterile environment. Typical donor sites include the abdomen, flanks or thigh areas. Depending on the philosophy of the surgeon, the fat cells can be modified with stem cell-enhancing maneuvers. However simple fat cell transfer is highly successful as a standalone treatment.
Next, the patient’s face is numbed with local anesthesia. Through small needle puncture sites (which disappear quickly), the fat is strategically placed to restore the 3-dimensional architecture of a youthful face. It is important that the fat cells are transferred as small micro-pellets or rice-sized granules. The smaller the fat droplets placed, the more likely the patient’s body will incorporate the newly placed fat cells with a fresh new blood supply, which is critical for fat survival.
3-D Facial Fat Transfer Results
Re-establishing volume the upper cheek area (malar fat pad) will give you an immediate result and more vibrant look. As for those “fat bags” under the eyes, they are often misunderstood as related to an increased amount of fat. However, in many cases the culprit is actually the loss of a more superficial layer of fat from the upper cheek area (malar fat pad) that unmasks the underlying fat pad just below the eyes. Facial fat grafting of the superficial layer of fat just under the eyes as well as beneath the upper eyebrow region can result in a more natural open awake look for the patient as opposed to a “surprised” look that may accompany more traditional surgery.
Procedure Q&A
1. How long is the actual fat grafting procedure?
Dr. Tom: A facial fat grafting session takes approximately one hour. The amount of time for the harvesting of fat is dependent upon what additional areas of body contouring are requested by the patient.
2. How much time do I need to take off of work?
Dr. Tom: There is no cutting so there is a minimal 1 to 2 day period of downtime. However there may be variable swelling and bruising from 3 to 7 days. (Click here for comprehensive safety and risk information.)
3. Does it hurt?
Dr. Tom: The majority of patients only require Tylenol or a low level pain medication post operatively.
4. How long will my results last?
Dr. Tom: A second fat injection session may be required approximately 3 months later. Facial fat graft transfers have been reported to achieve long-lasting results from three to eight years.
Walter W. Tom, MD, FACS is the founder and medical director of Aesthetic Laser & Vein Centers in Santa Rosa and Napa, Calif.