FACIAL FAT GRAFTING 

Facial fat grafting is a procedure that rejuvenates the face by countering facial volume loss. A compelling amount of research demonstrates that aging is not only gravitational but also volumetric, meaning that we lose fat in our faces as we age. Areas of the face where this is most noticeable include the hollows in the temples, as well as some of the facial lines that deepen over time such as the nasolabial folds and laugh lines. Some people also lose volume in their cheeks as they age as well. There have also recently been studies showing that grafted fat seems to be able to help with rejuvenation of the overlying skin quality.  The goal of facial fat grafting is to produce longer-lasting results which persist for many years, compared to fillers which usually last less than a year. 
 

Good candidates for this procedure:

  • Patients with facial creases, such as laugh lines, smile lines, and crow’s-feet that they would like filled in

  • Patients with sunken areas of the face, lips, and cheeks that they would like filled in

  • Patients seeking long-lasting facial volume

  • Patients seeking minor changes in facial volume
     

What to expect: Consultation

All cosmetic consultations are complimentary and serve as a great opportunity to gain further insight by voicing your concerns and having questions answered. During the initial consultation, Dr. Hsu will ask some questions to get to know you and determine if you are a good candidate for facial fat grafting.

Dr. Hsu will first ask you about your specific goals for facial fat grafting, including what areas of the face you would like to improve. He will also ask about your general health history, including any existing medical problems, prior surgery, daily medications, allergies, and any smoking habits.

Dr. Hsu will then give you his assessment on whether you would be a good candidate for the procedure, and if so, how the surgical plan should be individualized for your anatomy. Since each patient's anatomy and surgical goals are different, you and Dr. Hsu will work together to reach optimal aesthetic results. 
 

Surgery Details:

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On the day of surgery, arrive early to fill out paperwork, meet the anesthesiologist, and be prepared for surgery. Dr. Hsu will meet you in the pre-operative area before surgery to make markings on the areas planned for surgery and answer any last minute questions you may have.

Facial fat grafting is performed under general anesthesia for a duration of approximately an hour. After using liposuction to obtain sufficient fat from other parts of the body (often the abdomen or flank areas), the fat will be washed with an antibiotic rinse and inserted into sterile syringes in order to inject the fat precisely. To transfer fat most effectively, it must be carefully injected in very small deposits. This technique is crucial because injecting too much fat in one area will prevent the fat from receiving enough blood supply to live and heal properly.

Because a portion of the grafted cells are expected to be reabsorbed by the body, Dr. Hsu will inject slightly more fat than necessary to compensate for resorption. This resorption is a natural process that is safe and part of the healing process.
 

Recovery & Post-operative Instructions:

After the surgery, Dr. Hsu will wrap dressings around the surgical area which will remain there for the first week during healing. You must keep your head elevated during recovery periods, making sure to sleep on two pillows at night. We also recommend wearing a handkerchief or shawl to cover the area so that you will be more comfortable going outside. For most patients one week after surgery, bruising and swelling has subsided enough for makeup and concealer to cover any remaining bruising.

Most importantly, you should keep the surgical area dry until Dr. Hsu gives his approval to shower. To clean the rest of your body, you can bathe from the shoulders down. Dr. Hsu will usually remove stitches during your first week follow up appointment. Swelling & bruising will peak about 48 hours after surgery but will then decrease significantly in the first two weeks. Most patients can return to work after two weeks, but many patients return even sooner! The biggest limitation for post-operative patients is driving, which should be avoided while taking pain medication. Patients usually stop taking pain medication after five to seven days and plan their work schedules accordingly. Six weeks is usually an appropriate time to gradually return to full exercise and activity.

During the recovery period, we recommend walking within the house several times per day to speed healing and minimize the possibility of developing blood clots. If you have any inquiries, Dr. Hsu is available 24 hours following surgery through his personal cell number. For an extended period of time after surgery, Dr. Hsu will maintain regular contact with you to make sure you are healing well. Most follow up appointments are scheduled one week, two weeks, and several months to a year afterward. 
 

Dr. Hsu's view on Facial Fat Grafting.

I tend to use facial fat grafting quite conservatively.  In my experience, many of the age-related changes seen in the face can be best addressed with a mini-facelift, or a facelift.  However, there are some people who do lose a significant amount of fat in their faces with time, and in those patients, facial fat grafting can be a good choice of procedure.  Because facial fat grafting is often done in conjunction with liposuction, I generally prefer to do this with the patients under general anesthesia.

Although facial fat grafting can be done in many areas of the face, in practice I find that most of the patients requesting it are more in the temple areas, where they notice some hollowing out over time. I also get some requests for fat grafting to the cheek areas as well.