Facial fat transfer
Dr. Roy sincerely believes that among the major contributors of facial aging, generalized volume loss in the face plays a critical role. Although surgical techniques to lift sagging facial tissues can be very effective in facial rejuvenation, restoring volume in the face can significantly amplify surgical results and lead to much longer-lasting effects. This can be accomplished with facial fillers or implants, but cost, temporary treatment effect and increased risk of infection, extrusion or movement (in the case of implants) are important limitations of using such materials. Autologous fat transfer, wherein fat is carefully harvested from other body sites (most commonly the belly) and re-injected into the face in a precise and systematic fashion, can lead to long-term volumization of the face and restoration of a youthful facial contour, and in the majority of cases, is a more cost-effective solution. Fat transfer is usually combined with other procedures but is offered as an individual treatment modality. The major limitation of fat transfer is the variability of fat survival in the recipient site and a slightly longer recovery period from a facial swelling and bruising standpoint.
The procedure is generally done with local anesthetic and sedation (either oral or IV; depending on the extent of the transfer). Fat is harvested manually with fine harvesting liposuction cannulas attached to a low pressure syringe from areas of fatty excess, usually the abdomen, hips or thighs. The fat is then processed a sophisticated filtration system to purify and optimize the fat prior to facial transfer. Fat is then injected into volume deficient areas of the face with even finer cannulas using a series of very small “poke” holes to introduce the cannulas.
Generally patients are social after 10-14 days, with swelling and bruising being the most common hallmarks of the early recovery process. Low impact activities can be resumed after 2 weeks, with high impact activities acceptable after 3 weeks. The final result will be most evident at the 3 month mark.
Frequently Asked Questions
1. What kind of anesthesia is used for facial fat transfer surgery?
Dr. Roy typically performs facial fat transfer surgery under light IV sedation, although partial fat transfers may be done under local anesthetic and mild oral sedation. General anesthesia is not required.
2. How does Dr. Roy perform facial fat transfer surgery?
After anesthesia is induced and the donor site cleaned, fat is harvested from a part of the body that naturally contains more fat, often times the abdomen or upper thigh, using gentle suction. The fat is then purified in a specialized system to yield high quality fat for the transfer. A very fine blunt cannula (hollow tube) is then used to transfer this excess fat into those parts of the face that appear hollow. It is usually necessary to slightly over-fill the treated areas to compensate for some natural absorption of the transferred fat that occurs. This may cause the face to appear a little more puffy/swollen temporarily during the recovery.
3. Where are the incisions for facial fat transfer surgery and will there be visible scars?
The only incisions are at the harvest site (one on the abdomen, two if using each thigh), and these are generally less than half a centimeter and heal inconspicuously. The small poke holes used to introduce the blunt cannulas for the transfer itself generally heal very quickly and are undetectable a few days after surgery.
4. Will facial fat transfer surgery be painful?
Pain or discomfort is typically very mild after facial fat transfer procedures.
5. What is recovery like after facelift surgery?
No post-operative dressings or drains are used after facial fat transfer procedures. Overfilling, however, is often necessary and for this reason the face may temporarily appear puffy or swollen for a period of 10-14 days. Minor bruising or redness may also occur.
6. How much time off work will I need after facial fat transfer surgery?
While there are no facial incisions involved in fat transfer, swelling does limit return to social activities to 10-14 days. Most patients will take 1-2 weeks off work depending on desire to conceal the procedure from co-workers.
7. When can I exercise after facelift surgery?
Light walking can be resumed after about 1 week after facial fat transfer surgery. Low impact activities (such as elliptical, weight lifting, exercise bike etc) can begin after 2 weeks while high impact activities need to be restricted for 3 weeks.