Question:
Can fat injections improve tear troughs?

Answer:
Fat grafting can definitely improve tear troughs and, in fact, is the most common area that I personally place fat.  I most commonly perform this in conjunction with a lower lid blepharoplasty and oftentimes I am also performing other procedures, such as facelifts and brow lifts.  The overall effect is very natural appearing and very rejuvenating.

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Question:
I would consider fat transfer but are the results really permanent?

Answer:
I find structural fat grafting or fat transfer an extremely valuable tool in my ability to rejuvenate patients, but I typically use it as an adjunctive tool to other procedures.  In other words, I will use fat grafting to the mid-face and cheek area at the same time I am doing a lower lid blepharoplasty or a facelift.  This gives a very subtle yet very significant enhancement to the patient’s facial features and yes, I truly believe that at least a portion of the fat could be considered a permanent filler since about one-third to maybe one-half of the fat that is injected should develop its own blood supply and become viable transplanted fat that will stay there for an extremely long time if not permanently.

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Question: The lower portion of my cheeks to the sides of my mouth have become quite sunken looking as I’ve gotten older. Can fat injections be used here or would I end up looking like Marlon Brando from the Godfather?

Answer: Fat injections can definitely be placed in the midcheek to give added volume where someone has a sunken appearance and as long as the fat is judicially applied, you will not get the appearance of Marlon Brando from The Godfather.  In fact, I would even say that it would be nearly impossible to overfill somebody with that much fat in that location in a single fat grafting session and that it would most likely take at least two fat grafting sessions spaced about six months apart to give enough volume long term that it could be detrimental.  I would, therefore, feel very comfortable going ahead and giving a relatively aggressive fat grafting session to areas that are sunken as the ultimate result should only be a nice volumetric enhancement and long term you should not have any overfilling of that area. 

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Question: After my gastric bypass surgery, I lost a significant amount of weight. My face looks very empty and my skin is very loose. What types of facial surgeries would give me a fuller face and more youthful look?

Answer: Patients who have undergone gastric bypass surgery and significant weight loss still benefit from surgical procedures that are very similar to those who require rejuvenation surgery.  In essence, we are going to provide elevation to loose and sagging tissue and we will also volumize the face with fat grafting and/or facial implants.  Just as in rejuvenation surgeries, these need to be highly customized so that we create a very natural look and yet restore the patient’s appearance.  

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Question: Fat grafting doesn’t seem as popular as other procedures. Is it not as effective as surgery or fillers?

Answer: Fat grafting is overall a very popular procedure but certainly not as popular as injectable fillers simply because of the fact that injectable fillers have, for the most part, absolutely no downtime and are extremely easy and overall cost effective since you simply grab a syringe of filler off the shelf and we can inject it into appropriate areas of the face to give an enhancement and improve the aesthetics in a very simple way.  Fat transfer requires the harvesting of the fat, which involves liposuction of the belly or hips or knees and then we process the fat and then re-inject it using very small blunt-tipped cannulas.  Multiple passes with the cannula are necessary to maximize the viability of the fat and, therefore, patients have much more swelling than when compared to an injectable filler.  Surgery is going to be able to improve laxity and most often I am performing fat grafting in combination with other surgical procedures so that we can not only improve the laxity of the face but also volumize the face with the fat grafting.  This combination treatment gives the best overall aesthetic results.

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