Facial Fat Transfer
Taylor R. Pollei, MD
Fellowship Trained Facial Plastic Surgeon offers facial fat transplantation in Beverly Hills and Mission Viejo CA
What is Facial Fat Transfer?
Pollei Facial Plastic Surgery offers facial fat tranfers to achive your ideal look at our Beverly Hills & Mission Viejo locations. Also called “fat grafting” and “autologous fat transfer,” facial fat transfer/transplantation has the main goal of volumizing the face. It is ideal for patients that are volume deficient, and are wanting more permanent, lasting effects. Is not specifically for fine lines and wrinkles, although it helps him indirectly by improving the skin fullness and texture. It involves removing a small amount of excess body fat from either the abdomen, back, or thighs, and judiciously placed into the face. When used in the face, it restores lost volume and is most often placed in the cheek/midface area. It also can be used to volumize the lips, temples, jawline and chin. Fat transplantation is effective in treating sunken areas, lines, wrinkles, creases, and areas of scarring as well. Interestingly, in addition to adding volume, fat results in visible changes to the skin quality resulting in a more clean, uniform, and refreshed appearance to the skin. We believe that this is related to stem cell & growth factor related improvements to the skin in areas where it has been injected.
How would Fat transfer help my face?
As we age most people can look into a mirror and identify areas where volume is lost. This volume loss is seen in two forms. 1- Primary soft tissue loss: areas of the face where the fat and soft tissue under the skin just shrink with age. 2- hollowness left behind as a result of gravity-related fat and soft tissue descent. This is more often seen in the mid face/cheeks where the more substantial cheek fat starts to fall down & the jawline where marionette lines deepen as jowling occurs.
Fat transfer addresses both of these types of volume loss as well as other areas of the face where volume can be added much the same way injectable filler is used for the volumization. The difference between fat transfer and filler is that hyaluronic acid filler (the most commonly used type) is temporary, lasting anywhere from months to a year or two. Fat is permanent since it is a true tissue graft. Although there is some debate as to how much of the fat survives the transfer process and volumizes long term, it is, in fact, a permanent injectable substance.
How is Fat Transfer performed?
Fat transfer is performed as a standalone procedure, or in combination with other facial rejuvenation surgeries. When performed alone, fat transfer takes around 45 minutes to one hour. The surgery is performed as an outpatient procedure in my office-based surgery center facility located at the Lasky Clinic (Beverly Hills) or the Crown Valley Surgery Center (Mission Viejo). Fat is harvested via a liposuction technique from somewhere on the body where typically only 10 to 50 mL of fat is needed, depending on the areas to be injected. Fat can be taken from the abdomen (which is done through a tiny belly button incision) or from the outer thigh, inner thigh, or lower back/flank. The incision is only 2 to 3 mm long, and although uncomfortable the harvest site is not extremely painful postoperatively.
After being removed, the fat is gently processed in the operating room which takes about 10 to 15 minutes. It is then injected using an extremely small cannula (a thin, hollow needle-like tube) into the area to be treated. There are no facial incisions, thus no scars on the face from the injections. Depending on the amount of volumization desired and the area treated the fat is placed either deep or close to the skin surface. Both the donor site and injection site are numbed with injected anesthetic, and because fat is taken from your own body, there is no risk of allergic reaction or rejection.
Are there any visible incisions with Facial Fat Transfer?
No. I have found that in most cases, the donor site used is the area around the belly button, so the scar is hidden. Since the fat in this area is harvested through a tiny incision inside of the belly button, there’s no visible scar. Even if taken from the flanks, back, or inner thigh the scar is extremely small and heals well. Regardless of where fat is injected onto the face, since I use cannulas that are incredibly small, there’s no incision needed, rather tiny access points much like those used to inject filler in the office setting.
What is the recovery like?
The donor site can have some bruising and is uncomfortable for several days to a week following surgery. An ace bandage compression wrap is gently placed following the fat harvest. Dissolvable sutures are placed too close the small harvest incision and therefore do not need to be removed.
Although some facial bruising can occur and the face does feel slightly swollen, when a fat transfer is done on its own it does not result in extreme discomfort. Most patients do not require much more for pain than a few Tylenol. When done in conjunction with upper lid blepharoplasty lower lid blepharoplasty, or a facelift, the recovery is slightly more involved. Regardless I want patients to avoid straining, bending, heavy lifting, exercise or exertion for two weeks following surgery.
Most patients can plan on several days of laying low and typically are feeling more energetic, and ready to return to work/other easy activities by the one week point.
Are there any specific risks to a Fat Transfer?
Most typical surgical risks are present. Including bleeding, infection, or moderate bruising. In addition, with fat transfer, there can be some lumpiness or irregularity in the area following injection. This can be resolved with an injection of anti-inflammatory or can be camouflaged with the injection of filler in the office.
How long do the effects of Fat Transfer last?
Since the facial fat transfer is a true graft procedure the results are long-lasting to permanent. Much like hair transplant or a skin graft following a burn, the fat incorporates permanently where it is injected. Having said that not all fat injected develops a blood supply and thrives. We typically feel that up to a 30% loss of volume from what was injected can occur, and this is anticipated at the time of injection. Regardless, it is a very common for patients to continue having filler injections for age-related changes that continue to occur following fat transfer.
Contact our practice to learn more about facial fat transplantation where we serve the Beverly Hills, Mission Viejo, and South Orange County areas.