BEFORE AND AFTER PHOTOS
SCHEDULE A CONSULTATION
Fat injection is a very popular treatment on its own or in combination with other facial procedures. Today 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.
Advantages of Fat Injection
The advantages of fat injection compared with “off-the-shelf” fillers such as hyaluronic acid (HA) fillers (Juvéderm) include:
• It is your own tissue.
• There is usually an abundant supply so that large volumes can be injected.
• It provides living cells, some of which will survive the transfer and provide lasting results.
• Stem cells (adipose-derived stem cells) are injected with the fat.
Some investigators believe that stem cells can improve the quality of the overlying skin.
Is Fat Injection a New Procedure?
No, fat injection is not new, but definitely refined! When I was in residency in the 1980s, fat injection had a bad reputation. Some surgeons cautioned, “It looks good at first but then it gets absorbed.” In retrospect, this observation is not surprising. In the past, fat was suctioned and injected using high suction and injection pressures through small caliber needles that would break up the fragile fat cells. Fat injection received an upgrade with the development of liposuction. Plastic surgeons learned better how to manipulate fat and use less traumatic instruments. Influenced by the work of Dr. Sydney Coleman of New York City in the 1990s, plastic surgeons learned better techniques so as not to break up the fat cells when harvesting and injecting fat. This “kinder, gentler” fat transfer allowed fat cells to survive the transfer to their new location. Long-term results became possible.
Surprisingly, even today, many surgeons do not regularly perform fat injection. They may say that fat injection is just not predictable, or they have encountered problems with unevenness.
With proper technique and experience, predictability improves and problems become fewer. Fat injection should be part of every 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 almost every patient over the age of 50 undergoing facial rejuvenation. I also perform fat injection regularly in the hands and buttocks, and occasionally in the breasts and other parts of the body where filler is needed.
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 (there are a number of celebrities’ names that are mentioned as examples). However, women (and men) readily appreciate that their lip volume and fullness is less than it was when they were 20 years old. They have lost firmness, and the lips have 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 Other Fillers?
Yes. A patient who has had fat injection in the past can have injections of commercial fillers (such as Restylane and Juvéderm) afterward and vice versa. A patient may decide to have an injection of hyaluronic acid in the office, to see if she likes it, and return for fat injection later. Alternatively, a patient treated with fat injection may have a touch-up in the office with hyaluronic acid (HA) 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.