As we age, ligaments become lax and skin loses its elasticity. But another major factor in the aging face is volume loss. That is, we lose fat and therefore the skin falls back toward the facial bones, producing an older, more “skeletal” look, and resulting in wrinkle formation. This is also what causes sagging and hollowing under the eyes. Fat transfers (also known as autologous fat grafting) are an excellent way to correct the volume loss associated with the signs of aging. In addition to the face, fat transfers are commonly used to fill in depressions and dimpling caused by scars or prior infections (such as acne pitting). It is also commonly used to fill the back of the hand, when it has become bony and skeletal-looking.
FAQ's
What is “fat transfer?”
It is basically transplantation of fat from one part of the body to another. Technically called “Autologous lipotransfer”, it involves harvesting fat, (usually from the abdomen, outer thighs or love handles) then purifying it, and reinjecting it where it is needed, usually the face or the back of the hands. It can also be used successfully to fill in depressions from prior scars or acne. Because the fat comes from your own body, there is no risk of rejection or immune reaction.
Does it hurt?
Very little. Both the donor area (where the fact comes from) and the recipient area (where the fat is injected) are numbed using local anesthetic (Lidocaine) together with epinephrine (to control bleeding and bruising). No general anesthetic is needed or used. We typically use "conscious sedation" (also called twilight sleep) which involves giving you intravenous pain medication and sedation before we start the procedure (click here for more information on conscious sedation.) However, you can expect a mild amount of post-operative discomfort for 1-2 days, until the swelling goes down. We will supply you with pain medications if needed.
Which areas of the face are injected?
That all depends on where it is needed in each particular face. During your pre-op evalutation, we will determine, together with you, which areas would benefit most from this procedure. The most common areas to inject are the temples, forehead, brows, below the eyes, the “teartrough area”, the cheeks, the lips, the chin and the jaw line. We will usually ask you to bring a photo of yourself when you were younger. This helps us determine where to replace lost fat to your face.
Does the fat last a long time?
The biggest advantage of fat transfers is that they can last a very long time, several years or even forever. This is not always the case, and much depends on how many of the fat cells survive the first few weeks after transplant. Because the fat loses its blood supply when we take it out of your body, we have to use a very careful technique when we reinject it to make sure it develops a new blood supply in the new area. Not all the cells will survive, but typically 60-70% will remain long term. Areas with less muscle movement (such as around the eyes) tend to retain more of the fat. The chances of long-term survival of the fat cells are much better if we put in very small amounts at a time. Therefore, multiple sessions are usually needed to achieve the final result.
What are the dangers of fat transfers?
Although it is generally a very safe procedure, some of the potential risks are infection, bleeding, bruising, numbness, pain and irregular or lumpy outcome. If you have had cold sores (Herpes simplex), an outbreak may occur following your procedure. We advise using acyclovir, an anti-viral medication, prior to the procedure, to minimize this minor but annoying risk.
Can my body reject the tissue?
No. We are using your own fat, so there is no chance of a rejection or allergic reaction.
What is the downtime?
You will be swollen and possibly bruised for about a week. You will more than likely have some discomfort until the swelling goes down. You can go back to normal (light) activity within a few days, but your face will not look normal yet. It is best to wait at least a week to resume more strenuous activity. If possible, we suggest you take a week off to recuperate and let the swelling go down.
Do I have to go to the hospital?
No. We do the procedure in our own office. You can leave on your own 30 minutes after we’re done. You must bring a driver with you, however. The procedure may cause some swelling around the eyes, and may temporarily impair your vision, so it would not be safe for you to drive.
Does it cause scars?
Typically, no. We do make a few, small (about 1/4") incisions near your belly button (to collect the fat) and on your face (to inject it), but these almost always heal with minimal or no scarring.
Is one procedure enough?
Usually not. Best results are obtained with a series (usually 3) treatments, about 4-6 weeks apart. We will obtain enough fat the first time for all 3 procedures, and freeze what we don’t use, so it will be ready the next time you need a procedure.
What is the cost?
$1250 one-time fee for the initial fat collection (harvest), processing and freezing the unused portion. Then each injection is $350 for single area (both sides, of course), $450 for 2 areas, and $850 for full face.
If you would like more technical information, here is an excellent link: www.emedicine.com/plastic/topic59.htm
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