Melinda,
We struggle to re-educate the public all the time about the longevity of a fat transfer. The medical literature is full of articles claiming the contrary. If you read into the articles however you find that the science that claims that fat transfer doesn’t last have placed the fat in the area around the mouth and into the lips. In that case the science is correct. Fat is very unreliable when placed into the smile lines, marionette lines and lips. The reason for this is that the fat is a free graft and needs to acquire blood supply from the recipient area. The main force preventing this is movement. In the area around the mouth it is just too mobile for much of the fat to survive. This is in stark contrast to the area of the face that we place fat.
We first harvest the fat in a very atraumatic way. We then gently spin the fat so that all of the non-viable material is removed and only the good fat remains for injection. We are then placing the fat into the cheek and lower eyelid primarily. It is placed deeply right on top of the bone which is under the muscle. This is a very rich area for blood supply and immobile so the fat survives. Once it has blood supply it lasts for years. I personally have 4 year results and have presented my 2 year results at a national meeting. I have seen 10 year results and still going strong.
So in summary it lasts when performed correctly. Many of the photos on the site are 2 year results. Please take some time to review them and feel free to contact us with any other questions.
Ed Buckingham
Joan,
I can assure you that you will look like yourself, only better following your facial rejuvenation procedure. More specifically, the reason patients look unnatural after a brow lift is that the brow has been pulled too high, especially the central brow. This gives a deer in the headlights look. We usually perform endoscopic browlifts and focus on lateral elevation which is natural in appearance. Regarding blepharoplasty an unnatural look occurs when incisions are placed out of the natural skin crease and/or too much fat is removed. This gives the eyelid a hollow cadaveric appearance. By utilizing natural incision placement and preserving fat the upper lid maintains its natural look. With the lower eyelid we usually make the incision inside the eyelid, transconjuctival. This hides this incision. Again, only removing fat from the lower eyelid will lead to a hollow unnatural appearance. By performing a fat transfer we are able to fill the lower eyelid groove and cheek to restore volume loss in a natural way. By adding volume we are also able to give natural lower facelift results. A lower facelift can leave an operated look by moving hair from its normal position, poor scar placement or putting too much tension on the closure. We avoid all of these pitfalls with our incision placement and by performing a deep plane facelift. This allows all of the tension to be placed on the tough fibrous layers of the face and leaves the skin tension free.
The best way to convince yourself however, is to review our before and after gallery. I think you will agree that we provide substantial results, but in a natural way. Please feel free to call and to set up a consultation at your earliest convenience.
Ed Buckingham
Kelly,
Yes, we treat acne scarring. Each case is very different both from the degree of scarring as well as the patient’s tolerance for down-time. Treatment will begin by surgically excising any scars which are too deep for resurfacing. We then tailor resurfacing based upon severity and tolerance for surgical down-time. The Fraxel laser works moderately well for acne scarring with down-time limited to a few days with each treatment. For patients who are willing to have more down-time chemical peels and surgical dermabrasion are effective. In patients with a significant atrophic component to the scarring we utilize autologous fat transfer to plump the skin and reduce the pitting of the scarred skin.
I hope this helps to answer your question. Please feel free to call with any further questions. We would love to see you.
Ed Buckingham
Stacy,
Thanks for your question regarding fat transfer. In short, no a fat transfer will absolutely not make your face look fat. Depending upon your age, the fat in your face undergoes progressive loss or atrophy. In younger patients this may be limited to just the lower eyelid, as you age it becomes apparent in the other areas of the face. We tailor the fat grafting procedure to each patient based upon where they need the volume replacement. In all patients however we avoid putting fat in the areas of the face in quantities that would give the appearance of being over-weight vs. having a youthful face with good contour. The upper cheek, similar to a cheek implant, and the area under the eye is where the majority of the fat is targeted. This changes the relationship between the cheek and the lower eyelid to give the appearance of a youthful high cheek-bone without augmenting the lower cheek, which is associated with excess weight.
There is a more complete description of fat transfer on this website with many before and after photos. I encourage you to review this section and give us a call to schedule your personal consultation.
Ed Buckingham
Jane,
Thanks for your questions, sorry I have taken so long to reply. I have been out of the office and your questions were specific enough that my staff could not answer. Regarding your questions on rhinoplasty we can under most circumstances add length to a previously shortened nose. Usually in that case the nose has also been over-rotated. The limiting factor is when the nose has been very over-shortened and the skin has contracted so much that it prevents expansion to the degree that we would want. Usually though this is not the case. We may utilize ear cartilage for the repair or possibly rib depending on the amount of cartilage I determine is necessary to accomplish the best result. We have extensive experience with revision rhinoplasty and would be happy to see you. The cost for revision surgery is between 6,000 and 7,000 including facility fee and anesthesia.
Regarding Fat Transfer it depends on how you do it and where you do it. If your previous transfer was in the lips or perioral area then is was likely to fail and is likely to fail again. If you perform the transfer in the correct manner and are utilizing it to rejuvenate the peri-occular area, cheek area and jawline then it is usually successful on one attempt. All of the results on our website for fat transfer are after only one transfer. Not one patient on the site has had any more than one procedure and many of the results are longer than two years. In fact I just presented my long-term results for fat transfer at a facial plastic meeting. I encourage you to review the results and we look forward to the opportunity to meet you.
