Aging of the face is commonly caused by three elements: laxity of skin tissues caused by gravity, skin changes such as wrinkles and pigmentation caused by age and years of sun exposure, and the loss of facial volume that once created youthful curvature. That loss of volume hastens the look of aging and can prematurely date a person due to facial hollows. These areas are commonly observed under the eyes, below the cheekbones, and around the mouth, but also occur along the jawline, temples, brow and forehead.
*Each patient is unique and individual results may vary.
To correct a fatigued and often emaciated or harsh look, a plastic surgeon trained in facial aesthetics works to restore youth to the face. The face can appear dramatically younger by restoring volume to the under eye area, treating local wrinkles, creating a soft transition between the lower eyelid and the full heart-shaped cheek region, and filling the deep grooves around the mouth. Dr. Buckingham of Buckingham Center for Facial Plastic Surgery is an Austin, Texas-based practitioner who expertly performs facial fat transfer for patients.
How is Facial Fat Transfer Performed?
Areas of the body for fat harvesting may be marked out. The patient is then provided a combination of a local anesthetic and sedation (Oral or light IV sedation). In cases of full facial fat transfer, it may be more advantageous to use IV sedation to ensure optimal fat removal and operative comfort.
Sometimes referred to as microlipoinjection, autologous fat grafting, or fat injections, the procedure begins with lipoharvesting to areas of excess fat on the patient’s body. This process is performed through the use of a cannula, requiring only minimal incisions to access the tissue. While male and female bodies store bulk differently, the doctor is typically able to harvest this adipose tissue from the abdomen or hips. The fat may then be processed using rinsing, centrifuge or in Dr. Buckingham’s case the more sophisticated Puregraft system by Cytori. The Puregraft filter allows more reliable filtering of the unwanted components of the harvested fat. The doctor will then use a smaller cannula to reintroduce the fat to the patient’s facial areas in need.
Facial fat transfer is performed on an outpatient basis. However, patients will not be able to drive themselves home to recover from the procedure; a family member or friend can aid with this. Prior to the procedure, the doctor will provide any necessary prescriptions that can be filled before the surgery, and patients are encouraged to set up a comfortable recovery area. Pre-made meals, clean and comfortable bedding, and activities to cure boredom can all be set up before a patient undergoes the procedure.
Advantages to Autologous Facial Fat Transfer
There are a number of reasons why patients may choose to utilize their own fat for a facial rejuvenation. Dermal fillers and implants may be options for certain patients, while others have sensitivities or allergies to the synthetic materials. Because the body recognizes its own tissues, there is no chance that it will reject the replaced fat. In addition to the increased measure of safety, autologous fat contains stem cells, which can affect the growth factor of the surrounding area, contributing to healthier and more youthful tissue growth. While further processing of fat can isolate adipocyte derived stem cells, studies have not shown this to be superior to fat transfer utilizing the fat cell mixed with the stem cells. The stem cells that are already suspended in the fat mixture are reintroduced under the skin of the face without the added special treatment.
Because fat is a naturally existing tissue, it can create a natural texture and look that does not interfere with the patient’s facial movements, which is possible if implants are too large or become displaced. The fat does not move or shift as it becomes incorporated as living area tissue. It may also provide longevity of results, sometimes providing long-lasting volume restoration. Because the fat is injected into the skin, there are no facial incisions and only minimal surgical cuts to allow the small cannula (hollow blunt tube the size of the end of a pen) to suction fat from the body.
While fat transfer can provide outstanding youthful, natural results it does carry the downside that there can be variable survival of the grafted cells and the results can be suboptimal and it does create 1-2 weeks of significant swelling limiting return to social activity.
As previously mentioned, the face ages by gravity, skin changes and volume loss. If a patient’s main concern is overall aging of the face, facial fat transfer can be performed alongside a facelift blepharoplasty and skin resurfacing, depending on the individual’s needs.
Dr. Buckingham has found that in areas with a loss of volume and wrinkles, fat injections can address both issues; however, when the patient seeks to fill existing lines but is not concerned about re-plumping the general area of the face, dermal injections may be a better solution. JUVÉDERM® and Restylane® can fill grooves in the skin and BOTOX® (which is not a filler, but a neurotoxin) can prevent the lines from forming while the face is at rest and during minimized facial movements.
Recovery from Facial Fat Transfer
Patients can return home after the surgery for postsurgical care. There may be some noticeable bruising and swelling, but there is no need for post-operative dressings or drains. In most cases, the patient can return to social activities 2-3 weeks after the procedure depending on how much is performed. Strenuous activity can begin after 2 weeks with full activity at 3 weeks. It takes 3 months to determine how much of the fat that was grafted, the graft survival or take. If necessary, additional fat or facial fillers can be added in the future.
The Consultation – Determining Candidates for Facial Fat Transfer
To determine if a patient is a good candidate for facial fat transfer, Dr. Buckingham recommends a private patient consultation at his Austin, TX practice, Buckingham Center for Facial Plastic Surgery. This allows the patient to meet the staff, form a patient-doctor relationship, and hopefully begin the transformation process.
During this appointment, Dr. Buckingham will assess a prospective patient’s face to determine which single or combination procedure plan may be the best treatment for the intended results. He will also determine which harvest sites should be utilized during the fat removal process. During this initial meeting, the patient has the opportunity express any concerns and ask questions about the procedure.
Dr. Buckingham will assess the patient’s overall health, paying special attention to any chronic health issues or current medications. He may also inquire about previous procedures the patient has undergone, for both health and cosmetic purposes. Men and women are equally eligible for the procedure, and Dr. Buckingham can tailor individual results to retain feminine and masculine characteristics as desired. The results of the procedure will be discussed, and any patients that Dr. Buckingham takes on should have a good understanding of the facial fat transfer process and have realistic expectations for the changes it can provide. If it is determined that fat injections are not the ideal approach, the doctor may suggest alternate options, of which there are many.
Commonly, healthy patients with aged faces that appear drawn or hollow, especially under the eyes and in the cheeks, may be good candidates for autologous fat transfer. The aged lower eyelid can create a sharp line of demarcation between the lower eyelid and cheek referred to as a tear trough. Those seeking to restore volume and vitality to the face may find that this procedure addresses most or all of their cosmetic concerns.
Dr. Buckingham may follow up with tissue scans or request lab work and tests to maximize patient safety during this procedure.
Frequently Asked Questions about Facial Fat Transfer
What is facial fat transfer?
Facial fat transfer, also referred to as fat injection, is a minimally-invasive, outpatient procedure that counters facial aging like sagging soft tissues and wrinkled skin, specifically addressing regions that have lost natural fullness. Adipose tissue is removed from a fattier part of the body like the hip or abdomen through a minor liposuction procedure, and then strategically injected into different areas of the face. The injected fat may temporarily or permanently sculpt aging areas of the face.
Who is the best candidate for facial fat transfer?
Candidates for facial fat transfer are in good physical health and have realistic expectations for improving a maturing facial appearance. A consultation with Dr. Buckingham allows prospective patients to determine if facial fat transfer is the ideal cosmetic solution for their needs.
Are there any limitations to what facial fat transfer can achieve?
This form of fat grafting is limited in its ability to rejuvenate the lines around the mouth. These may need to be addressed with with fillers or skin resurfacing techniques, like a BBL Peel, Photofacial or IPL treatments.
How is the actual facial fat transfer procedure performed?
After the anesthesia has been administered and the donor and recipient sites are cleansed, fat is suctioned from the hips or abdomen, or another area with extra tissue. The fat may be treated, and is then introduced to areas of the face through a mini cannula. It is usually necessary for the treated areas to be slightly overfilled to allow for fat absorption in the weeks following the procedure. This may cause the face to appear temporarily swollen.
How long does the actual facial fat transfer procedure last?
In many cases, the procedure will be completed within an hour. If a patient opts to combine treatments, he or she can expect the procedure to take longer. The procedure is completed at an outpatient facility.
Is the facial fat transfer procedure painful?
Negative side effects are usually very mild with fat grafting procedures, but patients may feel some pain in the areas of fat removal, as well as discomfort in the face as it must be initially overfilled to produce optimal results. Dr. Buckingham can provide post-surgical instructions as well as prescription-strength medications to ensure patient comfort.
How long do the results of facial fat transfer last?
Dr. Buckingham has presented his 2-year results of fat transfer at national meetings and believes that the procedure can last anywhere from 5 to 15 years. The face will continue to age, and the factors that lead to the appearance of volume loss continue over the years. Typically, the procedure can erase 10-15 years from one’s appearance, so even as fat transfer patients age, they may still appear younger than their peers.
Schedule a Consultation
The first step to undergoing a facial makeover with Dr. Edward D. Buckingham is to schedule a consultation with him at his Austin practice, Buckingham Center for Facial Plastic Surgery. The skilled doctor is double board certified by The American Board of Facial Plastic and Reconstructive Surgery and The American Board of Otolaryngology. He is an expert in facial plastics and offers facial fat transfer to qualifying patients.
Contact the doctor by email through the Patient Contact Form, or by phone at 512-401-2500.