Fat Injection has been refined over the last decade and is now a very popular treatment on its own or in combination with other facial procedures. We recognize that part of the aging process involves loss of fatty tissue from the face. Restoring this lost volume is a key part of facial rejuvenation. In my practice, most patients having facelifts also have fat injection.

The advantages of fat injection over other fillers such as Juvéderm^TM

There is usually an abundant supply of your own tissue providing large volumes of living cells that can be injected to provide lasting results. Some surgeons believe the stem cells that are injected with the fat may also be helpful.

Is fat injection a new procedure?

No, fat injection is not new, but definitely refined!

When I was in residency in the 1980's, fat injection was not looked upon favorably by surgeons. The rap was that it looked good at first and then got totally absorbed. In retrospect, this is not surprising. Previously, fat was suctioned and injected, using high suction and injection pressures through small caliber needles that would break up the fragile fat cells. The fat cells would not survive the transfer intact. Prior to liposuction, large blocks of fat tissue were sometimes transplanted. Much of this fat would not survive because the cells were too far from the recipient blood supply.

Fat injection breakthroughs in the 1990s

Fat injection received an upgrade with the development of liposuction. Plastic surgeons learned better how to manipulate fat and use less traumatic instruments. Mainly through the work of Dr. Sydney Coleman of New York City in the 1990's, plastic surgeons learned better techniques in handling the fat so as not to break up the fat cells when harvesting and injecting fat. This allowed fat cells to survive the transfer to the new location. Long-term results became possible.

Why don't more plastic surgeons perform fat injection?

Today, many plastic surgeons still do not incorporate fat injection in their practices. Some say that it is just not predictable enough. Others have encountered problems with unevenness, particularly in the tear troughs where visible nodules can be troublesome. With proper technique and experience, predictability improves and problems become fewer. Fat injection should be part of the plastic surgeon's armamentarium because there is no better filler. It is one of the best tools I have learned since residency and I use it in most patients over the age of fifty undergoing facial rejuvenation. I also use it with regularity in the hands and buttocks, and occasionally in the breasts and other parts of the body where filler is needed.

How do fat injections help people who have lost bone?

Fat injection can be particularly helpful for patients who have inadequate bone stock due to cleft lip and palate at birth or in patients who have lost teeth. The bone tends to absorb without the presence of teeth. Teeth transmit stress to the bone and help keep it from dissolving. Fat injection particularly (because of the larger amounts available) can help fill out these tissues that have lost support because of bone absorption.

Fat injection in the lips

It is not unusual for women to be nervous about fat injection, particularly in the lips. They are worried about looking ridiculous afterward, like Goldie Hawn in the movie First Wives Club. However, they readily appreciate that their lip volume and fullness is less than it was when they were 20 years old. They have lost firmness as the lips progressively become more flaccid. I reassure them that the amount of fat injected can be conservative- simply a restoration of lost volume. Any woman who wears lipstick appreciates the aesthetics of lips. Increased lip volume is impossible to duplicate with lipstick or other commercial products that are applied to the surface. Lipstick that goes over the natural border of the lip looks unnatural, even "clownish."

Is fat injection compatible with Restylane^® and Juvéderm^TM?

Yes. A patient who has had fat injection in the past can have Restylane^® and Juvéderm™ afterward and vice versa. A patient may decide to have a quick injection of hyaluronic acid in the office, as an appetizer so to speak, and commit to a fat injection "entre" later. Alternatively, a patient treated with fat injection may have a quick touch-up in the office with hyaluronic acid at a later date to increase fullness or to compensate for any fat that has dissolved. Of course, a touch-up fat injection is also possible.