If you are considering facial augmentation, you may have a few questions you would like answered. Facial augmentation using fat grafts is not a new technique - fat transfer techniques have been around since the 19th century. As early as 1893, free fat autografts were used to increase the volume of soft tissues. Throughout the 20th century, attempts were made to use fat as a 'filler', but it was not until the 1980s that the concept of atraumatic liposuction and fat micrografting was developed. However, refinement of the technique has led it to be the procedure of choice for an array of problems.
You may choose to undergo facial augmentation for a number of reasons:
- To correct facial scarring
- To enhance the size and shape of lips
- To reconstruct small contour defects
- To enhance the shape and form of the chin and cheeks
The following frequently asked questions and answers (FAQ's) will give you a basic understanding of the procedure - when it can help, how it's performed, and what results you can expect. These may not answer all of your questions, since a lot depends on your individual circumstances. Your surgeon will be able to help you with any further concerns you have about how the procedure will affect you personally.
What is autologous fat grafting?
Autologous simply means the grafts are taken from your own tissues. Autologous fat grafting involves transplanting very small samples of fatty tissue from one area to another on your body, usually to increase volumes in deficient areas.
Why is it advantageous over other techniques such as synthetic facial fillers?
While synthetic fillers (hyaluronic acid, collagen, etc.) have the advantage of being available 'off-the-shelf', they remain chemical substances that are gradually broken down by the body. Fat grafting makes use of your own tissues, which eliminates any potential complication associated with foreign materials. At LPSA we do not advocate the use of permanent (non-resorbable) fillers.
Unlike the use of synthetic facial fillers, fat grafting does involve a second surgical site, for harvesting the fat cells. However, as this is usually from an area of excess, it is seen by many as an advantage.
Can it be used in facial rejuvenation?
In many patients, fat grafting is an extremely effective means of rejuvenating the face. It is often used in conjunction with other techniques (chemical peel, Botox) to restore youth and vitality, especially in patients with early signs of facial ageing but who do not necessarily want a face lift.
By re-creating the pleasing curves and volumes of youth, it combines the benefits of facial rejuvenation surgery with a relatively low-risk procedure.
How does it compare to a face lift?
In some cases, facial fat grafting may provide many of the benefits of a face lift, but without the scars and at considerably less expense in terms of risks and recovery. However, patients with excessive skin laxity and jowling are less suitable for fat grafting alone and may still require a face lift. The techniques are not exclusive, and are often combined to give excellent results.
Can it be done under local anaesthetic?
In smaller areas, fat grafting can be done under local anaesthetic, which reduces the complexity of the procedure. In large areas, a general anaesthetic may be preferable, especially if the technique is being combined with another surgical procedure. Fat grafting alone is always suitable for daycase surgery.
What takes place during the surgery?
Fat cells are harvested from an area that offers 'spare' volume, such as the abdomen or thighs in most instances. These are drawn up in to small syringes, and then spun in a centrifuge to purify the cell layer.
The cells are then injected into the area to be augmented, by laying down very thin columns of grafts along tunnels that are no more than 1 mm in diameter.
Are there significant scars?
No. Very small 'ports' are used to access the deeper tissues for laying down the fat cells. While several small scars may be necessary to obtain a good result, they are no more than 2-3 mm across, and usually hidden in naturally occurring facial lines and become imperceptible with time.
I have heard that some of the fat disappears with time - is this true?
Yes, because a percentage of the graft will not retain its volume, a slight excess of cells are usually transferred. In some cases, a repeat procedure may be necessary. However, the simplicity of the technique means that this surgery is well tolerated. Some patients retain fat grafts better than others, and the procedure may occasionally need to be repeated.