Structural fat grafting is a natural means of enhancing and rejuvenating the face. It can be done to achieve goals similar to temporary injectable fillers, but our technique of LipoStructure® has every indication of permanence.
In this procedure, fat is gently hand-suctioned from your body using a small incision that is generally hidden in a natural crease. The fat is then refined and separated using a centrifuge. The refined fat is then carefully and meticulously placed into the areas in need of improvement using small cannulas (tubes) passed through tiny incisions, that are again hidden in a natural crease or in the hair. Grafted fat can be used to correct depressions or hollows in the forehead, temples, upper and lower eyelids, nose, nasolabial folds, and cheeks. It can also be used to augment or enlarge the cheeks, lips, chin and jaw line and it can help to smooth the neck and improve the skin of the decolletage. It is an excellent option for anyone seeking a more permanent correction of lines, folds, hollows, depressions, or irregularities.
As we age, the temples begin to lose fullness and become hollow. This creates a skeletal, bony look that was not present when we were younger. Fat can be used to make the temples more full and make the bones less obvious. It can also have the effect of making the eyebrows appear slightly elevated, which is desirable with today’s fashion of a dramatic outer arch.
Youthful upper eyelids are full beneath the eyebrow. In addition, they have a short distance from the eyelashes to the eyelid crease, and a long distance from the eyelid crease to the eyebrow. As we get older, the distance from the crease to the eyebrow shortens and creates a longer distance from the crease to the eyelashes as the eyelid becomes hollow. Hollowing can also occur if too much fat is removed at the time of an upper lid blepharoplasty (eyelid surgery). This is an area that is often overlooked, but can be a giveaway when it comes to looking older. The current trend in eyelid surgery is to remove very little fat, if any, to maintain this fullness.
If it has been disrupted, the volume/crease relationship of the upper eyelid can be restored by adding fat back to the upper eyelid.
The lower eyelids may be naturally hollow and dark or they may become hollow and dark after the removal of too much fat during a lower lid blepharoplasty (eyelid surgery). This is another area where surgical technique has changed. As plastic surgeons, we had previously removed as much fat as we could find. Now the trend is to leave fat behind to prevent hollowing or to add fat back to correct it. This tends to help with smoothing the contours as well as minimizing the darkness that is partly due to shadowing.
Often, after a rhinoplasty, small imperfections may be noted in the nose. Sometimes the changes that you thought you would like are not optimal and you may want to restore some of your previous nasal contour. These imperfections and deficiencies can often be smoothed out or restored with the addition of fat. Though it sounds counterintuitive, fat can also be placed into the nose in such a way that it actually makes the nose look smaller rather than larger. Proper placement of fat can smoothe a bump and make the nose straighter as well.
The depressions that run from the sides of the nose toward the outer corners of the mouth are called the nasolabial folds. If these folds are deep, they can be minimized with the addition of fat. Despite the addition of fat, the folds will never be entirely gone, as that part of the face is constantly moving during eating and talking. Patients often come to me with concerns about their nasolabial folds. If they have large cheeks, I tell them that this is a natural facial shape, as even babies can have folds if they have full cheeks. In addition, it is often not the nasolabial fold that is the problem, but the front of the cheek. If volume is lost in the front of the cheek, it creates a depression that breaks the cheek into two parts and accentuates the nasolabial fold. It is a difficult concept for some patients, but correcting the cheek contour by augmenting the area with fat often improves the appearance of the folds.
As the cheeks lose volume, a diagonal depression often appears that seems to accentuate the nasolabial fold. In addition, the area beneath the cheekbone often becomes more hollow, creating a gaunt look. Fat grafting can restore lost volume to the cheek or the area beneath the cheek. It can be used to fill in the diagonal depressions, but it can also be used to create the more prominent cheekbones that you may have always wanted.
The depressions that run from the corners of your mouth toward your chin are called the marionette folds. These folds can also be improved with fat grafting, but again, because of the significant movement of the mouth, will never be entirely absent.
Fat grafting can be used to create lips that are more full and youthful, as well as to correct irregularities. Ideally, the lower lip is at least the same size or larger than the upper lip. Both the upper and lower lip can be treated and augmented at the same time. Fat grafting to the lips creates significant temporary swelling, but it will leave you with a natural, lasting change in lip contour.
Adding volume and projection to a small chin can dramatically improve the balance of the face. In addition, as we age, there is some loss of volume in this area, making the chin flatter than when we were younger. Rather than using an artificial implant, your own fat can be used to sculpt your chin.
As we get older, we lose volume along the front of the jaw line by the chin and in the back of the jaw line near the ear. This creates a wavy, loose-looking contour in an area that was likely straight and smooth when we were younger. This can be corrected by grafting fat. In addition, a naturally small or poorly defined jaw line can be augmented to make it more pronounced.
The neck is a difficult are and one of the first to wrinkle and become lax as we age. Placing a thin layer of fat beneath the neck skin can help to improve the contour and texture.
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