Facial Fat Grafting Scottsdale
As we age, our faces begin to show the effects of gravity, sun exposure and years of facial muscle movement, such as smiling, chewing and squinting. The underlying tissues that keep our skin looking youthful and plumped up begin to break down, often leaving laugh lines, smile lines, crow’s feet or facial creases over the areas where this muscle movement occurs.
Soft-tissue fillers, most commonly injectable Juvederm or fat, can help fill in these lines and creases, temporarily restoring a smoother, more youthful — looking appearance. When injected beneath the skin, these fillers plump up creased and sunken areas of the face. They can also add fullness to the lips and cheeks. Injectable fillers may be used alone or in conjunction with a resurfacing procedure, such as a laser treatment, or a recontouring procedure, such as a facelift.
Knowing your options with Synthetic Soft Tissue Fillers or Fat Injections
Injected synthetic soft tissue fillers and fat are primarily used to improve the appearance of the skin’s texture. They can help fill out deep facial wrinkles, creases and furrows, “sunken” cheeks, skin depressions and some types of scars. They can also be used to add a fuller, more sensuous look to the lips.
Injectables are usually not sufficient for severe surface wrinkles on the face, such as multiple vertical “lipstick lines” that sometimes form around the mouth. Instead, Dr. Lille may suggest a resurfacing technique, such as a laser treatment. Rather than filling in facial lines, resurfacing methods strip away the outer layers of the skin to produce a smoother appearance.
Deep folds in the face or brow caused by overactive muscles or by loose skin may be more effectively treated with cosmetic surgery, such as a facelift or browlift. Injectablessuch as botox or Juvedermare sometimes used in conjunction with facial surgery procedures; however, injectables alone cannot change facial contour the way surgery can.
Keep in mind that Dr. Lille is a specialist that can offer you the full range of the most advanced treatments ranging from cosmetic surgery, refinishing techniques, laser therapy, injectables and the use of other fillers. You and your surgeon may determine that a single procedure or a combination of procedures is the best choice for you.
The most important fact to remember about injectable fillers is that the results are not permanent. Injected material is eventually metabolized by the body. You should not expect the same long-lasting results that may be gained from cosmetic surgery.
In some individuals, the results may last only a few weeks; in others, the results may be maintained indefinitely. Researchers believe that age, genetic background, skin quality and lifestyle as well as the injected body site may all play a role in the injected material’s “staying power.” However, the precise reason for the variation of results among patients has yet to be identified.
The Procedure: After both the donor and recipient sites are cleansed and treated with a local anesthesia, the fat is withdrawn using a syringe with a large-bore needle or a cannula (the same instrument used in liposuction) attached to a suction device. The fat is then prepared and injected into the recipient site with a needle. Sometimes an adhesive bandage is applied over the injection site.
“Overfilling” is necessary to allow for fat absorption in the weeks following treatment. When fat is used to fill sunken cheeks or to correct areas on the face other than lines, this overcorrection of newly injected fat may temporarily make the face appear abnormally puffed out or swollen.
After Treatment: It is important to minimize talking and facial movements for 5 days. You can expect some swelling, bruising or redness in both the donor and recipient sites. The swelling and puffiness in the recipient site may last several weeks, especially if a large area was filled.
Results: The duration of the fat injections varies significantly from patient to patient. Though some patients have reported results lasting a year or more, the majority of patients find that at least half of the injected fullness disappears within 3-6 months. Therefore, repeated injections may be necessary. Your doctor will advise you on how to maintain your results with repeat treatments.
Fat Grafting Q&A
1) What is fat grafting?
Dr. Lille harvests fat from different areas of the body which can include abdomen, hips, knees, thighs and transfers them to areas that require augmentation, which is most commonly the face.
2) How is this performed?
The region of the body that has a viable and plentiful donor source of fat will be locally anesthetized. Then, specialized fat harvesting instruments under hand aspiration will gently remove and then process through centrifuging, removing unwanted material from the fat cells. At this point, the donor graft contains healthy fat tissue and stem cells. This is then further washed and purified and then re-implanted using, once again, specialized fine facial transfer cannulas into areas of the face.
3) How long does the fat last?
There is inevitably some absorption of the fat that can range depending where the fat is transplanted. Usually, anywhere from 20%-50% will be absorbed. We have often found that the areas along the jaw line and cheek and temporal region usually maintain 70% survivability.
4) What happens if I have a higher amount of fat graft absorption following the procedure?
A secondary procedure can always be performed to obtain the patient’s desired results.
5) Does one area of the body from where the fat is taken have a higher survivability than other areas?
Multiple studies have been conducted to address this question. Although studies have been inconclusive at this period, generally the lower abdomen has been the area with the highest degree of favorability. Regardless,
wherever the fat is, it must be able to be removed via an a-traumatic fashion so as to not injure the fat cells during the harvesting technique. If the fat cells are injured, then the probability of survival is significantly decreased.
6) Where can the fat be placed in the face?
The fat can be placed anywhere there is a need. Dr. Lille often places the fat along the jaw line, pre-jowl areas, around the mouth, in the cheek, the temporal areas in front of the ears, along the orbital rim, the brow areas and sometimes along the glabella nose junction.
7) Is there one area that Dr. Lille does not like to graft on the face?
The lips have been a difficult area to predictably obtain graft survivability. The lips are constantly moving and this makes it very difficult for the fat graft to take micro-vascularization. It is very important that symmetry is achieved in lip augmentation. Unfortunately a small difference from one side of the grafted lip to the other can be appreciated by the patient. As such soft tissue fillers such as Juvederm may be more optimal for lip augmentation.
8) How big are the incisions for fat grafting?
The incisions are very small and are placed in strategic areas of the face and require no sutures and heal very quickly without a noticeable scar.
9) Does Dr. Lille use fat to graft in other areas of the body?
Dr. Lille also uses fat to augment the buttock region. The patient however must require a significant amount of fat usually around the hips, the flanks, and lateral thighs to provide sufficient amount of fat to augment the buttock region.
10) What is the recovery from fat grafting to the face?
Fat grafting to the face is a quick recovery. There can be, however, bruising that can last up to a week, with noticeable generalized swelling to the face that can potentially last up to two weeks. Returning to a desk job can be as early as five to seven days; however, if extensive fat grafting to the face is performed, patients may want to extend their leave to ten days to minimize the noticeability. Physical activity can resume in ten days.
The final result is usually obtained within two to three months and any fat that has not survived will be complete at that stage.
11) What do I need to do to prepare for the surgery?
Make sure you have refrained from taking any substances that can thin out the blood like aspirin, ibuprofen, Aleve, Advil and other similar medications. Bleeding complications or excessive bruising can result. Also, it is best to refrain from naturopathic substances that have excessive vitamin E/C or contain glucosamines. A list of refrained medications will be given during the initial clinic visit. Also, if the patient is older than 45 or has concurrent medical issues, a medical clearance test from your primary medical doctor may be required. In some cases, depending on certain factors associated with the patient, only tests without seeing the primary doctor can suffice.
12) What is the process if I want to schedule surgery after the initial consult?
After the initial consult, a surgery date that is convenient to the patient along with a another clinic appointment to go over pre-operative issues such as medication list, obtaining photos, consents, along with pre-op and post op instruction direction documents.
13) Is smoking harmful for fat-grafting surgeries?
Tobacco ingestion either with smoking or chewing has shown in studies to significantly increase the risk for fat loss. We do not know the exact time to reduce this risk to normal, but a 6 week cessation before the surgery MAY be effective.
14) What types of anesthesia are available?
Dr. Lille likes can use general or sedative anesthesia. All anesthesiologists are board-certified and use a rubber insertion device inserted inside the back of the mouth to reduce any discomfort that may result from general anesthesia.