Fat Transfer-Volume Restoration of the Aging Face
Hollow eyes, flattening of the midface, deepening of the nasolabial fold, thinning of the lips. These changes are all associated with the aging process. They reflect loss of subcutaneous tissues, muscle and underlying bone. Traditional surgical rejuvenation procedures such as face-lifting and blepharoplasty reposition tissues but fail to add volume, often leaving patients with a tighter look but not a younger look. Fat transfer or autologous fat transplantation has been used for many years. Fifteen to twenty years ago it was terrible. The fat would be suctioned out from the stomach or hips with a high powered liposuction machine, washed in a strainer, and placed back into a large syringe for placement. The fat would generally be placed in a large blob under the skin. The doctor and patient then watched as the fat slowly disappeared. Most patients did not hold onto this fat. The body simply broke it down and took it away.
Over the years, research began to shed light on what fat needs in order to survive. Out of this, new techniques were developed. With the new technique, the fat is harvested very gently with a few mm of pressure. The fat is centrifuged (spun around very quickly) and separates into layers. The intact fat is removed and used to fill the desired areas of the face. Long term success is enhanced by placing the fat in the tissues in a microdroplet fashion as opposed to a large bolus.
The common areas for fat transfer are the upper and lower eyelid area to soften hollowness and deep set look: the temple area, corner of mouth, jaw line, cheek creases, and thin lips.
Any time living tissue is moved from one area to another there is a possibility the fat will not make it. With improved techniques, fat transfer has shown it is still present years later for most patients. Patients may elect to have another fat transfer session years after to add additional volume.
Patients may experience bruising and swelling lasting 1-2 weeks. Most people are back into their activities by the end of two weeks. Final results are generally evident by three to six months.
Maloney Center for Plastic Surgery- Atlanta,GA
© Copyright 2000 American Academy of Facial and Reconstructive Plastic Surgery
