Facial Fat Grafts for Volume Restoration

As we begin to age we begin to loose volume from our faces. This can start in the 30's and it is a progressive volume loss or "deflation" of the facial features.

Children and young adults have nice soft, round features which over time change to more angular features with sunken in eyes, flattening of the cheeks, development of jowls and loose skin and muscle bands in the neck. Loss of facial fat alone might not make you look old, but will give the impression that you are not well, matter of fact you look like you have a serious illness. Aging also causes decrease in muscle bulk, bone loss, loss of skin elasticity which produces sagging and wrinkling of the skin. Everyone ages at a different rate, which is genetically determined (intrinsic aging), but this can be speeded up by our behavior of smoking, overexposure to the sun, excessive alcohol intake, stress and lack of sleep (extrinsic aging).

Some of these changes can be reversed or slowed down with structural fat grafting to the face. Fat is the human "play- doh". Fat grafting has been around for many years and results have been variable. I believe this is a very technique dependent procedure and if you don't pay attention to detail, treat the fat gently and inject it in a correct way, yes, you will get suboptimal results. I use Dr. Sydney Coleman's micro fat grafting technique. He is the foremost authority in this area in the USA and internationally.

The fat can be harvested from any area of the body, but the abdomen and thighs are the most common sources. The harvesting is done under gentle, low manual suction with a syringe and a small canula to preserve the viability of the cells. I centrifuge the fat at low rpm to separate the serum and the oil from the damaged cells. The viable fat is gently loaded into 1cc syringes and injected with a very small, blunt injection canula. It is important to place small amounts with each pass and to place it in multiple locations: deep above the bone, into the muscle, above the muscle and under the skin. The fat should not be massaged because this action can displace it to unintended areas and can also crush it. The temporal hollow, cheeks, lips, marionette lines, prejowl sulcus, acne scarred skin, deep nasolabial folds, tear trough deformities, sunken in eyes and deep forehead lines can be corrected with micro fat graft technique. The best part is that the fat is your own tissues, you can't reject it. There's evidence that the injected fat contains stem cells as well, and these might be responsible for the rejuvenative changes in the skin that is seen after fat grafting.

Although fat injections to the face are the most popular site, other areas of the body can be treated as well. I use fat grafts for buttock augmentation, correction of depressions after previous liposuction, and more recently around breast implants to soften capsular contractures or thicken up the tissues to correct "rippling".

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