Facial Fat Grafting
- Facial Fat Grafting Overview
- Am I a Candidate for Fat Grafting?
- Your Initial Consultation
- Getting Ready for Surgery
- The Location of Your Surgery
- Anesthesia
Facial Fat Grafting Overview
Fat grafting to the face, (also called: facial augmentation with fat, fat transfer, micro-lipoinjection, facial fat rejuvenation, autologous fat grafting or transfer, or fat injection) is a novel, unique, cutting-edge technique that is utilized by Dr. Zemmel at Richmond Aesthetic Surgery. Most of the time, it is performed as an adjunct to other facial rejuvenation procedures (such as a facelift or eye lift). Fat grafting takes fat from one area of your body, and then transfers it to the face through a very small syringe as microfat particles. It is commonly used in the lips, the nasolabial folds (parenthesis lines), marionette lines, the under-eye areas, and the cheeks. By a certain preparation technique used by Dr. Zemmel at Richmond Aesthetic Surgery, the fat is transferred along with its natural unique stem cells to the face. By doing so, it adds volume to areas of the face that have deflated over time, and helps contour a more round, youthful, and natural appearance.
As an injectable filler, your own fat is almost perfect. It is soft and feels natural, it does not cause immune problems, and it is your tissue. The fat is harvested from some other spot on your body, such as you abdomen, and can be a by-product, if you will, of liposuction. Dr. Zemmel uses it as a great minimally invasive approach to rejuvenate the face and restore a youthful volume.
Am I a Candidate for Fat Grafting?
Fat grafting surgery can be performed on almost all healthy individuals who have specific issues with the shape, volume or configuration of their face. Facial aging always includes a loss of volume in the face, and thus all individuals can use additional corrective volume to some degree.
Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Zemmel at Richmond Aesthetic Surgery.
You must be mentally and emotionally stable to undergo a cosmetic procedure. Please consider this before committing to a procedure. Importantly, you should have the procedure done for yourself, not to fulfill the desire of someone else or to try to fit an unrealistic ideal image.
You may not be a good candidate for fat grafting if you have a history of poor wound healing or if your overall health is poor.
Your Initial Consultation
In your initial consultation, Dr. Zemmel at Richmond Aesthetic Surgery will evaluate your face, including the skin and underlying bone, its shape, and how much volume you need. Dr. Zemmel will discuss your goals for the surgery and whether you are a candidate for facial fat augmentation.
Dr. Zemmel will check for medical conditions that could cause problems during or after surgery, such as uncontrolled high blood pressure, blood clotting problems, or the tendency to form excessive scars. He will also ask you about previous facial injury or any surgery you may have had. It is important to be candid and upfront about previous surgeries and your expectations.
Be sure to tell Dr. Zemmel of Richmond Aesthetic Surgery if you smoke or are taking any drugs or medications, especially aspirin or other drugs that affect clotting.
When you decide to have facial fat augmentation, Dr. Zemmel will explain his technique, the anesthesia that will be used, the facility where the surgery will be performed, the risks, and costs involved.
Do not hesitate to ask any questions you may have, especially those regarding your expectations and concerns about the results.
Getting Ready for Surgery
Dr. Zemmel will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Following these instructions will help your surgery go more smoothly.
You should arrange for someone to drive you home after your surgery and to help you out during that night.
The Location of Your Surgery
Dr. Zemmel at Richmond Aesthetic Surgery performs facial fat grafting at St. Francis Hospital’s Ambulatory Surgical Center. Fat grafting is done on an outpatient basis. Dr. Zemmel always calls each patient personally at night to ensure their safety and see how they are feeling.
Anesthesia
Dr. Zemmel performs his procedures in the safest method for his patients. He performs facial fat grafting surgery under local anesthesia with “twilight” anesthesia or general anesthesia to minimize discomfort and provide for the safest and best surgical environment.
The Surgery
Facial fat augmentation takes Dr. Zemmel at Richmond Aesthetic Surgery differing times depending on the extent, intricacy, and plan of surgery. It can take as little as thirty minutes to over a couple of hours to safely perform the procedure.
Fat grafting can be done on almost all areas of the face and body:
- Areas under the eyes
- Tear troughs under the eyes
- Temples
- Cheeks
- Chin
- Lips
- Jaw line
- Forehead
- Fat grafting can also be used to help fill in scars on the face and has been used on the buttocks and hips and the sternum.
The site being treated must have good blood circulation and enough capillaries and larger blood vessels so that the injected fat cells are nourished and can form their own blood supply. This is a key factor in getting the best and longest lasting results.
This procedure involves both a donor site (where the fat is taken from) and the treatment site (where it is being put). Usually, the donor site will be the buttocks, abdomen, or outer thighs. If you are having liposuction for body contouring, the fat taken for the face will be performed first prior to the large volume of the liposuction.
The first part of the surgery starts with Dr. Zemmel infiltrating some fluid into the donor site area. This fluid contains a medication to help decrease the risk of bleeding and also contains a numbing medicine. Dr. Zemmel removes the fat with small syringes and cannulas. The fat is then treated to remove blood and other fluid and any damaged fat cells. Usually this is achieved in a centrifuge or treated in some other way to remove excess fluids and separate out damaged fat cells. Whole healthy fat cells are best for reimplantation. The fat (which looks like a yellowish liquid in the syringe) is then injected using a separate smaller hypodermic needle in the face. Dr. Zemmel at Richmond Aesthetic Surgery uses small puncture sites at inconspicuous areas to inject the fat to the designated facial areas. The puncture sites are no bigger than getting blood draws on your arm. These small sites heal well with no signs of any surgery and usually do not even need a stitch! There will be no dressings on the surgical area, but a thin layer of antibiotic ointment may be applied.
Post-Operative Course
After the procedure, Dr. Zemmel will bring you to the recovery room where you will be monitored until you are ready to be released. Most people are released about 2 hours after the procedure is finished. Your face may feel tight and tender as the anesthesia wears off, and your donor site may be sore as well.
You will need to be driven home by a responsible adult because you will not be able to drive yourself home. Dr. Zemmel at Richmond Aesthetic Surgery has noticed that most patients do not have much pain or discomfort, but you will be given appropriate pain medicine to lessen the discomfort. However, if you believe your pain to be out of the ordinary once you get home, call Dr. Zemmel at Richmond Aesthetic Surgery immediately.
After surgery, it is of the upmost importance to keep your head elevated. You will need to sleep sitting up in a chair or with multiple pillows for the first 3 days. There will be no dressing applied to the surgical sites, but a thin layer of antibiotic ointment twice daily can help with the healing process. Applying ice to your face during this time can also alleviate some of the pain and swelling.
You may shower the day after surgery and clean your small sites from surgery.
You will be seen by Dr. Zemmel in the office the following week to see your results and assure that you are progressing in a normal fashion. Keep in mind, however, that there is still a lot of swelling in the face and the final results will not be fully seen for three to six months.
Surgical Complications
When fat augmentation to the face is performed by a qualified plastic surgeon, complications are infrequent and usually minor. The main risk of the surgery is the amount of fat that survives. There is about 30% of the fat or more that the body just naturally absorbs. One thing to remember is that every individual heals differently, and some will absorb more fat than others. However, the fat that is taken up in the face and rebuilds the volume will last forever!
Complications that can occur include: a hematoma (a collection of blood under the skin) infection, problems with skin loss and wound healing issues, asymmetry, contour irregularities, hard nodules, numbness, reactions to the anesthesia, and the need for revisional surgery. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no assurance that things will heal as expected. In some situations, it may not be possible to achieve optimal results with a single procedure and a second minor fat grafting procedure may be necessary.
Dr. Zemmel at Richmond Aesthetic Surgery will instruct you how to reduce your risks of complications before surgery and will provide you with a full set of instructions after surgery as well.
Feeling Normal Again
Fat grafting has little downtime from an activity and energy standpoint. The night after surgery and the following day you may feel a bit tired and not yourself. However you will quickly feel back to your usual self within the first week. Although you may feel well that first week, you will still be very swollen and possibly have bruising that will be visible when you go out in public. Dr. Zemmel at Richmond Aesthetic Surgery will give more specific guidelines for gradually resuming your normal activities.
Your New Appearance
Most of the swelling decreases and absorption of some fat will take place in the first 6 weeks to 3 months; however, a small percentage will gradually take a full year to occur. You will be excited with the transition and new shape of your face. You will love the additional volume and contour; it will place you back to a more youthful appearance!
Contact Richmond Aesthetic Surgery
If you would like more information on facial fat grafting procedures, or if you would like to schedule a consultation to talk more about your options, please contact Richmond Aesthetic Surgery today.
Directions to Our Office
Dr. Zemmel is proud to provide his plastic surgery services to patients traveling from nearby cities. For your convenience, we have provided driving directions to our practice from the following locations: