Most people think of liposuction as a way to lose the unwanted fat cells from the body; however, years of experience have taught us that youthful and the most beautiful faces are full of fat that is in the right places. As we age, we lose the volume to our face. Not only does the skin sag, but the underlying fat pockets that are normally present begin to dissipate as well as the underlying bony structure begins to resorb. This all leads to an overall reduction of volume which makes the overall appearance of the face cave in and sag, and we make the analogy that the face is similar to a beach ball filled with air and when the face is old it’s like that same beach ball that has lost its air. It becomes flaccid and wrinkly. Therefore, facial fat grafting has been a mainstay of facial rejuvenation over the past 15 years. This procedure is not new; however, it has been described as far back as 40 to 50 years ago by several colleagues of mine. However, fat grafting gained a lot of media attention around the early 2000s. Fat grafting done correctly can help to restore youthful contours to the face and reduce the severity of the hollowness and deep wrinkles that form. Rarely fat grafting alone is enough to rejuvenate a face and it is most often used as an adjunctive procedure to other more significant lifting procedures. In my practice I tell patients that fat grafting is like icing on the cake. It’s that little bit extra that can put the results over the edge from good to great.
Theoretically, fat has stem cells and regenerative healing potential; however, this is only in theory and has not been proven to any extent, but it is nice to know that it is possible that the fat that has been injected is having some long-term benefits above and beyond the initial cosmetic benefits that are seen. Every patient should know that fat grafting to the face is not guaranteed to be permanent. Sometimes it can go away fairly quickly, but in general, for most people fat has good longevity to it, much more so that the usual fillers. When fat is done correctly, it is very safe and gives great natural results. Fat grafting is a very artistic endeavor for the surgeon who is performing it. It is commonly done by people who don’t have extensive facial training and therefore there are plenty of patients in the world who have had fat grafting that didn’t turn out well; however, when it is done by a skilled and trained facial plastic surgeon with an artistic eye, the results are very predictable, very safe and very highly effective. Facial fat grafting has been a very effective technique that I use in conjunction with my facial surgeries and I plan to continue to use fat in conjunction with my facelifts for many years to come.