Fat Transfer to the Face


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Video Transcript:

Today, I’m talking about fat injection to the face. Fat injection to the face is a 7 or 8 10-year-old new concept. Any concepts in plastic surgery that are of 10 years old are really a new concept.

Now, how did this come about? How this came about is we started to analyze the ageing face and we started to reevaluate the facelifts we were doing in the past, and blepharoplasty, the eye surgery we were doing in the past.

In the past, we were taking a lot of fat out of the eyes, hollowing the eyes, trying to get a younger look. And we decided that maybe we were going backwards when we’re doing this.

When we are young, we have a full, round face. We have more volume, more fat in the face. As we age, we lose volume in the face and we lose skin tone and our supporting ligaments fall.

And so now, the idea is let’s fill the face to the way it used to be when we were young. So now, adding volume is kind of the key to facial rejuvenation to the ageing face. You almost are behind the times now if you do a facelift and do not do fat transfer to the face along with your facelift. You are behind the times if you are doing a lower lid surgery and taking out more fat than you are repositioning.

So now when we’re doing lower lids and eyes, we want to reposition the fat. We’re not trying to take it all away. When we’re doing facelifts, we’re adding fat to the center of the face along with our facelift and tightening skin and tightening the facial layers. So that’s the idea of the fat transfer to the face.

I would argue that the fat transfer to the face may be more important or as important as the facelift. And here’s the reason why. When we look at this patient here, this is a patient that is got a good skin, a young person, youthful person but we’ve lost is we’ve lost in some of the fullness in the face. We have more of a flat face, more of a linear face. We have a long eyelid. We have the cheeks that are low and hollow. The face is just too flat.

When we’re children, we all have round faces, and that’s the look of youth. So when we’re doing the fat transfers, what we’re trying to do is put fat back into those compartments. We’re trying to give that look of youth.

Now, the other part of the story is the magic stem cells. Fat has a lot of stem cells. And we’re getting some improvement with blood vessel. We’re getting some changes with the skin with the stem cells. And you can just see after the fat injection, the quality of skin is a little bit better than it was before.

So now you can see what we did with patient was we did fat injection to the cheeks, to lower lid to nasolabial folds. So we’ve taken this flat face and now, we’ve given it some fullness and rounded it out by adding the cheeks.

If you look at the lengthy lower lid before and now she has a short lower lid of youth. When we look at ourselves in our 20s, our cheeks are right up next to the pupil. They’re not way down here. And so that’s why this face just looks younger than that.

When we fill this compartment, we fill the lower lid, we fill the cheek, we fill the nasolabial fold, you’ve given that look of youth. And again, if you look, the cheek is hollow. The lower lid is very long. Now, we get that short lower lid and the full cheek.

So that is the idea of the fat injection to the face. This is the face is fuller, the skin quality is better. This is just a younger person than this. This is 10 years of youth.

Now, the big thing about the fat transfer it’s forever. When you add the volume and you do a fat transfer, what you’re doing is a nonvascularized tissue graft. It is similar to a skin graft. If I had a third degree burn and to fill this burn in my hand, I would take the top half of the skin from this hand and place on the open wound. The recipient side of the open wound would as it heals, blood vessels will grow from the recipient side to the skin. If the fat gets a blood vessel, it lives. If it doesn’t, it dies.

And that is the same thing we’re doing with the transfer. We’re doing a liposuction and taking the fat from someplace else, the stomach or the legs or wherever. And then when we inject it to the face, as it heals, the blood vessels from the recipient side will grow into fat cells. The fat cells will get a blood supply, live. Those that don’t, die.

We expect about 60% of the fat we put in to get a blood vessel and give a permanent result. So once it takes, it is forever changed. So that’s the big glory of the fat transfer. And I would argue for this lady, a fat transfer to the face is a better result than a facelift would have been because if you did the facelift without a fat transfer, the cheeks will still be hollow. The eyelids would still be long. And that’s not the look of youth.

And you can just see this is just a younger look than that. You can see the fullness of the cheek. You can see the wideness of face. The face is rounder instead of flat and hollow. You can see the fullness of the cheek, the short eyelid. Look at the length of the eyelid. The eyelid is probably half as long as it was before the surgery. This is a wonderful procedure. The fat transfer is a very nice procedure and it does very well.

Now, the other side of the fat transfer is you have to do liposuction to harvest the fat. So if you want a small waist, there you go. You can do your liposuction get a small waist and a flat stomach, and then use the fat into the transfer.

Now, the recovery from this, the most painful part of this is the harvesting zone for the liposuction. So that will hurt just like any other liposuction. But the infection of the face is just really more swelling. People don’t really complain about pain in the face. It’s just some throbbing and some swelling but not really so much pain. The pain is the donor site.

Now, you will be very swollen for one week up to 10 days and it will look like you got hit in the eye. It would just be very swollen. So most people, need about a week off at the minimum after the surgery before they get back out because the face is so swollen. You will still be swollen at that week but it will be reasonable.

It will probably take about 3 weeks to 6 weeks for all the swelling to go down to get your look, maybe even more, you get a good idea at 6 weeks but maybe 3 months gives you the final look and you know exactly what it looks like.

But all in all, it is a very good procedure and makes a very good change. It is not very terribly painful. It’s really the donor site that is painful from the liposuction . But the fat transfer to the face I think is a very, very nice procedure and makes a very, very good change.

I would still argue that it may be more important than a facelift, maybe as important as a facelift. And if you do a facelift, you should do the fat transfer with it because you’re fumbling on the one yard line if you don’t. You must shorten the lower lid to get that little baby eyelid. If you don’t get that nice, full cheek with the short eyelid, if you leave that with the facelift, you’re only doing literally half of the job.

So I think this is really growing procedure. And I just think it’s something that a lot of people just think about. If you have any questions, you can email them to the website. I’ll try to do my best to give you the answer, give you the best answer I possibly can and we’re going to try to do more videos and you take care. Bye.