Fat Transfer: A Facial Rejuvenation Technique

By J. Charlie Finn, MD

Published on August 01, 2006

One of the newest trends in cosmetic surgery revolves around what we call "volume replacement." Until recently, rejuvenation surgery involved treatment of the skin through tightening or repositioning. However, much of facial aging occurs as the soft facial tissues are lost with aging. As the bone and fatty tissue of the face reabsorbs, support to the skin is lost, which contributes to drooping and wrinkling. Luckily, a revolutionary new technique of replacing subcutaneous tissue is now being used.

Fat transfer has been performed for years, with varying results, but recently new techniques have been refined to dramatically improve the longevity of transferred fat. First, fat is gently liposuctioned by hand using tumescent liposuction techniques - the safest method of liposuction. Fat may be harvested from any area of excess (abdomen, thighs, or hips). The fat is carefully purified and concentrated. The facial areas are anesthetized and tiny droplets of fat are injected into the subcutaneous tissues. (By injecting small droplets, longevity of transferred fat is enhanced.)

A multitude of areas can be enhanced. Lips can be augmented, the nasolabial folds can be filled, hollows under the eyes can be filled, and cheekbones and jaw lines can be made more prominent.

Leftover fat is processed and stored in a tissue freezer for later injections. If fat is readily available, enough is harvested to provide for several injection sessions. Frozen fat may be re-injected for up to two years.

Initially, areas are overfilled and there is some reabsorbing of the injected fat. There is also some bruising and swelling on the face that may last for several days. As the augmented tissues settle in, areas will likely require further filling. With successive injections, further longevity can be expected. Slight overfilling is performed with these successive injections, as some reabsorbing is always an expected aftereffect of fat transfer. Different people metabolize transferred fat at different rates and some will require more repeat injections than others.

The net effect of Fat Microtransfer is a very natural appearing rejuvenation without any hint of a "stretched" look. By using one's own tissues, allergic reactions and side effects that can be seen with other filling materials are minimized. Improved contour of the donor area is an added benefit. Indeed, some patients will choose to proceed with contour liposuction on various areas as well.

This procedure may be combined with other procedures as indicated. Fat Microtransfer is a relatively new procedure, and doctors will continue to refine techniques to achieve the best long-term enhancements possible.

J. Charlie Finn, MD is President of the Cosmetic Surgery Center of North Carolina, and Assistant Consulting Professor of Surgery at Duke University.

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