A Long-term Solution to Facial Volume Loss
Fat Transfer Scottsdale, Arizona
As we age, we lose the facial volume that gives us a vibrant, youthful appearance. A variety of injectable treatments exist to replace collagen while eliminating facial wrinkles, hollows and folds, but some patients are seeking a more permanent solution. A fat transfer restores facial volume using fat harvested from other locations on the patient’s body, for long-term rejuvenating results. To learn more about cosmetic facial procedures, including fat transfer surgery,
contact Dr. Pamela Henderson in Scottsdale, Arizona.
An Introduction to the Fat Transfer Procedure
A fat transfer can effectively improve areas that have lost volume as a result of the natural aging process, and enhance lips that are thin due to aging or congenital factors. As the face ages, hollowing typically occurs in the mid-face involving the Malaria (cheekbone) region, Vocal (mid cheek) region or both. When hollowing deepens below the eyes and along the eye socket margins, the appearance of dark circles worsens. This may begin in the inner portion of the lower lid, in the tear trough region. With continued volume loss, a depressed grove may extend through the mid-face. Continued deflation results in drooping of the skin and deepening of the folds between the nose and mouth (nasolabial folds).
As the loss of volume causes the mid-face to flatten, the underlying bony structure becomes more prominent. In some patients, a small fat pad located at the upper, outer portion of the cheek, just below the eye socket, appears to enlarge when in fact it is the volume loss below this fat pad that is the cause. While patients often confuse this fat pad for the fat within the eyelid, it is not addressed with lower lid blepharoplasties. Options for improving the hollowing of the orbital rim include lower lid blepharoplasties with fat pad repositioning, injectable fillers (Restylane®, Radiesse®) and fat transfer procedures.
Once the hollowing extends into the mid-face, options for improvement include cheek implants, injectable fillers (Restylane®, JUVÉDERM®, Radiesse®), injectable collagen stimulants ( Sculptra® Aesthetic) and fat transfer procedures. Mid-face lift, which specifically addresses drooping of the mid-face, is also limited if volume is lacking and can result in an unnatural, flattened, and stretched appearance if volume is not replaced. Except for cheek implants, the remaining options are also appropriate for treating the hollowing in the Vocal regions. For enhancement of lips, options include injectable fillers, permanent implants (Perma Facial Implant™), surgical enhancement (vermillion lip advancement, nasal base lift) and fat transfer.
The Fat Transfer Consultation
Prior to a fat transfer procedure, patients will visit the Scottsdale, Arizona office of Dr. Henderson for a consultation. Assessment of facial volume is important when discussing facial rejuvenation (including procedures such as a face lift or mini face lift). Although skin laxity, Howling, neck fullness and neck banding are addressed with surgical lifting procedures, these procedures alone do not address volume loss. If being seen for lip enhancement, the size, shape, and vertical length of the cutaneous (skin) and vermillion (red) portions are assessed.
Options for improvement, including the pros and cons of each, are discussed allowing the patient to make an informed decision about which technique is appropriate for them. Factors such as longevity of results, risks, cost, and downtime are reviewed. Since not all the fat survives the fat transfer, and occasionally none does, patients are advised that repeat treatments are likely to be needed. These are generally spaced several months apart.
Preparing for Surgery
Once the decision is made to proceed with fat transfer surgery, patients are scheduled for a preoperative appointment approximately two weeks prior to the surgical date. During that appointment, patients are given preoperative instructions and consent forms are reviewed. These instructions generally include avoiding medications that increase the risk of bleeding including herbs, vitamin E, aspirin, and NSAIDS such as ibuprofen. Smoking should be discontinued at least two weeks prior to the procedure and two weeks after the procedure to increase the chances of survival of the fat.
Anesthesia
Fat transfer alone can be performed under local anesthesia with or without oral or intramuscular relaxation/pain medications as an outpatient procedure. If combined with more extensive procedures, or if desired by the patient, fat transfer can also be performed under twilight anesthesia (local combined with intravenous medications) in Dr. Henderson’s certified in-office surgical suite. If performed alone, the procedure can be completed in around an hour.
The Fat Transfer Procedure
The donor sites for fat transfer are typically those that maintain fat, and are often described as the areas from which patients have difficulty losing fat, even when they are at their thinnest. The most common sites are the hips and lower abdomen but can include thighs, upper abdomen, and back. The donor site is injected with local anesthesia and the facial areas are anesthetized with a combination of nerve blocks and infiltration. After making a small, discreet incision (often in the bellybutton) the fat is gently harvested manually into 10 ml syringes, processed and then injected using small Cannulas (blunt needle-like instruments) on 1 ml syringes. The fat is layered within the soft tissue to distribute the fat at various levels to increase the chance of survival by increasing the exposure to surrounding vascular tissue for nutritional support. A small amount of over-augmentation is performed but extensive overfilling is avoided to decrease the central portion from not receiving adequate nutrition as it establishes blood supply.
After Surgery
Following the fat transfer procedure, patients are advised to ice the area to minimize bruising and swelling. Although not guaranteed, chilling the area may also improve the fat survival by slowing the metabolism. Bruising gradually resolves over seven to ten days but swelling – which may be felt as firmness – may persist for several weeks. Normal activities may be resumed after approximately one week but strenuous exercise is to be avoided for at least two weeks.
Risks
Although uncommon in association with the fat transfer procedure, complications can occur with any surgery. These include but are not limited to bleeding, infection, asymmetry, and numbness.
Learn More about Fat Transfer Surgery
Fat transfers naturally and permanently restore facial volume for a youthful, vibrant appearance. If you are interested in fat transfer surgery, contact Dr. Henderson in Scottsdale, Arizona to schedule a personal consultation.
By placing her focus exclusively on facial procedures, and surgeries involving the head and neck, Dr. Henderson has consistently provided patients throughout the greater Phoenix area with outstanding facial rejuvenation results.