Part of what makes a youthful face is the presence of subcutaneous fat. This is what keeps skin smooth and unwrinkled and produces round cheeks and soft lips. However, over the years this fat is lost, or pulled downward by gravity and creates sagging. Being able to restore this support is an important skill for a cosmetic plastic surgeon. Here’s a look at the ways a cosmetic plastic and reconstructive surgeon can replace lost fat to remove wrinkles and sagging.
Fat grafting is a process where the doctor removes fat from an area of your body, like your abdomen or thighs, and re-injects it into your face where fat has been lost. This has the advantage of being inexpensive — only a small amount of fat is needed. Another plus is that your fat contains stem cells, which can help to heal and rejuvenate your facial tissue.
However, fat grafting requires a different technique than ordinary liposuction. The fat has to be kept alive through the process. This means using a large cannula to harvest it so the cells aren’t damaged. This can be uncomfortable for the patient and also requires more of the doctor performing the operation; preferably it should be a cosmetic plastic surgeon. It is easiest to use fat grafting when the patient is already anesthetized, for example when performing a surgical face lift.
There are a variety of fillers available that can be used to support and stretch out your skin to remove wrinkles. Fillers are usually stiffer than biological fat, which makes them easier for the surgeon to work with. They can also be applied with regular sharp needles, which are usually more comfortable for the patient. Our practice offers the following fillers: Botox, Restylane, Perlane, Juvederm, Sculptra and Radiesse.
Because they are easy and simple to work with, fillers are better for quick “touch-up” jobs where only a small part of the face needs to be restored, such as around the eyes or lips.
In the end, neither fat nor fillers is strictly superior. Which one works better depends on the individual case. A good cosmetic surgeon will be able to judge which one will work better for you and explain why.
