Fat, or adipose tissue, provides the structural support to the skin.
This is crucial in providing a healthy and youthful appearance to the
skin. The next time you observe a young child, look at his/her cheeks,
and then compare to an older individual around you. You will find that
with a few exceptions, facial aging is associated with flatter cheeks,
and sunken folds around the mouth. This occurs because with time, some
of the fat is lost, and some droops with gravity to form the jowls. What
is left is not enough to support the skin over the cheeks, and therefore
one sees the folds around the mouth and the eyes, and flattening of the
face. Similarly, the fat of the hands is lost with time, making the
veins and tendons very visible. Lipofilling can help restore the
fullness and the appearance of more youthful hands
Traditionally, collagen and
hylauronic injections are used to correct the folds around the mouth and other
lines on the face. These are very useful in the beginning of the aging process,
but may not be enough as more fat is lost. Many people seek a facelift to trim
the excess skin, but end up with a hollow face. When there is a loss of volume
of the face, volume replacement is ideal to help restore a natural appearance.
Think of a balloon that is deflating over time. The treatment is not trimming
the balloon, but filling it with air again!
|Before & 1 month after lipofilling of the cheek. Note fuller appearance. (Dany Touma, M.D.)|
concept of lipofilling
While most people gradually lose the fatty layers that provide the
structural support for facial skin, they retain ample amounts of fatty
stores in other areas, such as the hips, outer thighs and buttocks.
The idea is simple: One of these
areas as well as the face is numbed using local anesthesia. Fat is suctioned
using a small syringe and a gentle needle. This is like a micro-liposuction
procedure (in fact many of my patients that undergo liposuction chose to have
some fat re-injected into areas that need correction). The suctioned fat is
gently transferred into the face or hands in a sterile, non-traumatic and
artful way to recreate the lost contour.
Like any other transplanted tissue, it is somewhat unpredictable how
much of the transferred fat will survive. Most studies have shown a
"take" of about 40%. Individual results vary though. In my own
experience, while some patients have had superb results that were
sustained over years after a single treatment, a few others have had
less impressive results. In order to maximize results, I recommend
re-injecting at three and six months. This serial injection approach is
needed to provide the maximum chance of a long lasting result.
Before and aftre lipofilling of the cheeks. The result was
the equivalent of gaining several Kgs in weight. (Dany
to prepare for surgery
The procedure takes about 90 minutes. No sutures are placed. Oral
antibiotics are started the night before the procedure and help decrease
the risk of infection. Mild bruising or swelling might develop, but most
people are able to resume normal activities the same or next day.
Bruising is minimized by avoiding aspirin, aspirin-like products,
vitamin E, alcohol and herbal medicines for ten days pre-operatively.
art of lipofilling
It is useful to bring an old picture of your early adulthood. This will
help in achieving individualized recontouring of your face. Areas
usually corrected are the cheeks, lower eyelids, folds around the mouth,
the lips and the hands. Occasionnally, defects left after liposuction
are also corrected with lipofilling. The result is beautiful and
natural rejuvenation of the face.