Written by Frank P. Fechner, MD
When we thoroughly study the changes associated with facial aging we begin to understand that it actually is as straight forward as we may believe. One insight into this enigma of aging is gained by comparing the different procedures used, both surgically and non-surgically, to counteract changes that time has brought. Although fat grafting was described before, it was only about 8 years ago that a few aesthetic surgeons used fat injections to provide volume to the face for rejuvenation. Until then, the maxim was “lifting – lifting – lifting” until normalcy was entirely removed from a person’s face.
Although perfection is still not available, I believe that we moved much closer to where we really want to be. My view has been that the answer lies not in face lifting or volume. Rather, it is the combination of tightening what has dropped and volumizing what is sunken that will provide the most logical approach with the most natural looks. As a result from this revelation, I perform about 98% of facelifts in combination with some fat grafting.
The injection of fat is a minimal invasive procedure where I extract the fat from areas of abundance (most commonly the hips, lower abdomen or love handles), purified and re-injected into specifically defined facial regions. This fat grafting procedure certainly is challenging technically. In addition, the outcome will only be as good as the esthetic eye of the cosmetic surgeon performing the procedure. Afterwards, the results will hold up for years because the enhancement is provided by living fat cells rather than absorbable fillers.
This patient is 10 months after fat transfer in addition to a browlift and lower eyelid lift. Although no facelift was performed, she appears more youthful and energetic. The hollowed areas have been replaced by softness and the patient’s face seems to “flow” much better.