Fat Injections: A Boon or a Bust?

The popularity of fat injections has risen and fallen, and appears to be on the rise again. The realization that many of the facial changes of aging are due to the loss of volume of both soft tissue and bone, has dramatically increased the use of fillers. Because the commercially available fillers are relatively expensive, fat grafting has been attractive as a relatively inexpensive source of a large volume of filler material, material that is native to the patient and should not cause allergic reactions.

Fillers

Fillers are becoming an increasingly important tool in facial rejuvenation. It is interesting that most patients are unaware of the range of uses that fillers can be put to. Collagen was the first filler to find widespread acceptance, but, because of its short effective life, it is now used much less.

The MACS-Lift (Short Scar Facelift)

In 2001 Belgian physicians Patrick Tonnard and Alexis Verapelle described the MACS-Lift (minimal access cranial suspension lift), a modification of the S-lift. Because of its effectiveness, combined with the short down time and relative safety, the MACS-Lift has become the most requested facial rejuvenation procedure in Europe.
The MACS-Lift differs from a traditional facelift in that the incision is only anterior to the ear and does not extend behind the ear. There is much less skin undermining so the blood supply is sturdier and the risk of tissue loss is much less when compared to other lifts. The underlying tissue is suspended with firm sutures and, in the extended MACS-Lift, additional sutures are placed to elevate the malar fat pad, reducing the nasolabial fold. In the MACS-Lift the skin is pulled upward rather than partially backward as in the traditional facelift. This results in a more natural appearance as contrasted with the "wind tunnel" look often seen with the traditional facelift. Because of the more limited undermining the post operative swelling is much less and recovery is quicker.  In most  cases the MACS-Lift  produces results that are  equal or superior to the  facelift.  At the  same time the MACS-Lift  offers the advantage of being  less invasive,  less expensive and safer than the facelift.

Youthful skin

Youthful skin has certain characteristics that separate it from older skin. Youthful skin is all of the same color. Despite those who think that freckling is "cute", this beginning pigmentary change can be one of the first steps in what has been called dyspigmentation. It is only a matter of time before other discolored areas begin to appear, leading to an unsightly "muddy" appearance. Sun exposure is the most common, but not the only cause for this condition. Pregnancy, hormone use and other factors can also contribute.
Youthful skin has high light reflectance and radiance. It is smooth and soft. With age, muscle movement and environmental exposure the skin becomes less smooth and sometimes rough. Fortunately we now have a variety of ways to turn back the clock and make skin look younger and behave like it's younger.

Volumizing 2

Filler can be used not only to restore volume, but to redistribute it. Even people who do not have much in the way of wrinkles can benefit from the addition of volume. The earliest signs of aging begin around the eyes and upper cheeks. Hollowness and flatness develop under the eyes at a relatively young age. The "bags" that people start developing under the eyes are almost always the result of deep tissue loss revealing the normal musculature of the lower eyelid.
High cheekbones are a sign of youth, of high estrogen production. These disappear with time, and can be recreated with filler. The same holds for a youthful appearance of the lower eyelid and nearby cheek. People are currently unaware that this can be done, but when they see before and after photos, they are almost uniformly attracted to the results. See the results at this link to our web site Facial Sculpting

Volumizing

The loss of volume, due to shrinkage of the deeper tissues is a critical part of the aging process. This is becoming more widely recognized and is the newest frontier in cosmetic surgery. It used to be thought that removing the excess skin would be enough to make people look younger. In some cases it is, but more often than not the use of filler is still necessary for an optimal result. The people who have a lot of extra skin are usually of normal weight, or on the thin side. When the skin is tightened, hollows become more evident. Use of fillers at this point greatly enhances the result. The time may come when we may do major correction of aging faces with filler rather than with surgery, but that is cost prohibitive at this point.