One of the most valuable developments in our understanding of the dynamic process of facial aging was the realization that volume loss from fat atrophy is a significant contributor to the tired, worn, and progressively hollow appearance of the aged face.
Facial Fat Grafting – Volume Restoration
With time, skin loses its elasticity and lines appear on the surface from repetitive muscle pull, weight fluctuations and gravity. Additionally, the decline in facial soft tissue padding leaves your once optimally expanded taught skin, deflated like a balloon that has lost its air.
Restoring volume in critical areas of face allows us to re-expand the deflated skin and blend transitions from one facial feature to another. Plumping up the underlying soft tissue framework puts gentle tension on the overlying skin, which can actually soften the appearance of deep folds and wrinkles. Re-establishing smooth facial contours while highlighting the cheekbone and jaw line are paramount in achieving a natural youthful result. Volume draws the eye to desired areas of the face. Fullness in the wrong places can widen the face and washout important borders and angular features. Sometimes less in the right place is more!
Dr. Deniz Basci completed specialized aesthetic fellowship training and has expertise in facial rejuvenation with both fillers and fat grafting. She will tailor a customized treatment plan based on your goals, personal anatomy and tissue quality. Knowing how much volume and precisely where to place it to give you the most natural result is more than a technical skill; it’s an art!
Dr. Basci’s goal in facial rejuvenation is to create imperceptible lid-cheek and lip-cheek junctions, smooth transitions from convex to concave surfaces, define the jaw line and eliminate jowling. Volume restoration with facial fat grafting or fillers is just one tool. Many patients seeking total facial rejuvenation undergo complimentary procedures such as face lift, neck lift, eyelid surgery, and laser resurfacing to ensure a well balanced natural result.
- Before Surgery: 1 hour consultation with Dr. Deniz Basci with 3D medical studio photography to customize your treatment plan and answer all your questions followed by a pre-operative visit the week before you scheduled procedure
- Surgery: 0.5-2 hours depending on your individually tailored operation
- Anesthesia: Local Anesthesia in the Office, or Sedation or General Anesthesia performed by a licensed physician depending on whether you are having other simultaneous procedures
- After Surgery: Go home the same day to begin recovery
- 2-3 days of mild pain and discomfort where the fat was harvests, Most are able to return to work and light aerobic exercise the next day; expect temporary bruising, moderate swelling, and areas of numbness and tingling where the fat was harvested, and moderate to intense swelling where the fat is placed
- Expect gradual improvement in swelling and areas of numbness and tingling
- 2-3 months before the “final result” if fat grafting is performed alone, incisions are fully mature and swelling is substantially resolved, time for another round of fat grafting or minor revisions
Common Places for Facial Fat Grafting
- NAround the eyes
- NLower lid-cheek junction
- NCheeks – midface
- NNasolabial folds
Facial Fat Grafting Techniques:
Each person’s volume restoration goals, anatomy and tissues are unique when it comes to facial fat grafting. Dr Deniz Basci has advanced training and expertise in facial rejuvenation and will design a customized treatment plan based on your specific needs. The amount of fat and the number of areas being treated will largely determine the length and nature of your procedure. When performed alone, facial fat grafting can be completed in the office under local anesthesia.
Facial fat grafting begins by identifying target areas of the face to fill and donor sites from which the fat will be harvested. Usual go-to donor sites include the inner thigh, love handle or lower abdomen, but you can talk to Dr. Basci about your preference. One or two 1cm incisions are made over the donor site and liposuction is performed to extract the liquid gold fat and stem cells. The harvested fat cells are then prepared and meticulously injected into the hollows of your face. If your procedure is performed under local anesthesia in Dr. Basci’s office, you can even participate in determining how much volume is enough and where you want more plump. Ultimately, it is up to Dr. Basci’s discretion but your satisfaction increases the more involved you are in the process!
Preparing for Surgery
Prior to any surgery Dr Basci will review your general health history, surgical history and current medications. You will need to stop taking any medications or supplements that increase the risk of bleeding 2 weeks before surgery and remain off of them for 2 weeks following surgery. Make sure to check with your primary prescribing physician before stopping any medications.
It is important to prime your body with a healthy balanced diet in the months leading up to surgery. Make sure you have the appropriate protein intake. Protein is vital for healing.
Recovery from Facial Fat Grafting Surgery
Just as every individual procedure is distinct, so is everyone’s recovery experience. Most patients will go home the same day as their procedure, unless they underwent simultaneous procedures such as a face lift or tummy tuck. You should expect moderate bruising and swelling of your donor site and moderate to intense swelling and bruising of your face. The swelling typically peaks on post-operative day 3 and then gradually begins to resolve.
You may shower the same day as your surgery. Avoid applying direct pressure to your face during the first few weeks. This is to avoid inadvertently causing pain or disrupting your surgical site before it has healed and your fat graft has had a chance to take root.
Any non-dissolving sutures will be removed in the office at your first a post-operative visit. You will need to apply a thin layer of ointment to your incisions once a day until they are fully healed and protect the incisions from sun exposure. Talk to Dr. Basci about when it is safe to begin silicone scar treatment.
You can resume your regular balanced diet and regular activities of daily life immediately following your procedure. Dr. Basci recommends you sleep with your head propped up on several pillows or semi-upright in a recliner for the first week after surgery to minimize swelling. You should expect to be moderately swollen during the first two weeks. This will gradually improve along with any bruising, numbness and tingling. It typically takes 2-3 months for the swelling to substantially resolve and at least 12 months for the incision scars to fully mature.
You may begin light exercise after your procedure. Dr. Basci recommends you avoid intense exercise, heavy lifting, yoga and pilates for 1-2 weeks after your facial fat grafting. Most patients resume full activities 2 weeks after surgery.
Frequently Asked Questions
- How long will my fat grafting result last and how much of the fat survives?
Facial fat grafting is typically permanent. Only 50-75% of the injected fat will stick around, but the fat that survives is there for life. It will even fluctuate with your weight changes. Not uncommonly, patients require more than one facial fat grafting session depending on their goals and individual anatomy. Dr. Basci recommends you wait at least 3 months before having another injection session.
- How soon after my treatment will I see the result?
Immediately after your procedure you will see a difference! Swelling begins during the treatment and peaks around day 3. The swelling and bruising will gradually resolve over the next 4-6 weeks. Dr. Basci tells most patients they’ll be “restaurant ready” with a touch of make up the week after their procedure. You won’t be “camera ready” for an important event like a wedding, television appearance or family reunion for 2-3 months.
- Do you over fill an area expecting some of the volume to go away?
Not in the face! There’s no room for error in the face. Subtle volume adjustments create significant changes in appearance. We have no guarantee how much of your injected fat will survive. Our best estimate is based on experience, proven research, and the results of other patients. But each body is unique! Over correcting volume in the face can look very unnatural and is not easy to fix. Unlike hyaluronic acid filler, which can be dissolved with a simple injection on the spot, fat is forever!
- What’s the difference between fat grafting and filler? How do I choose?
Both fat graft and hyaluronic acid fillers are natural substances that are found in the human body that are terrific tools for restoring volume. The difference is that hyaluronic acid filler is not your own tissue and does not come from your body. It is manufactured commercially and is a wonderful tool for delicate changes. Results from fillers are only temporary and are easily reversible with a simple injection to dissolve the product. Fat is forever! Fat grafting does not have to be repeated every few months, but it is not as straightforward to remove if you don’t like the result.
During your consultation with Dr. Basci she will assess your needs and give you an honest professional opinion on which treatment is best for you.