SURGICAL REJUVENATION OF THE FACE
COSMETIC SURGERY OF THE NOSE

9.2 FAT GRAFTING OR LIPOSCULTURE AS A FILLER

FAT INJECTION IS SAFEST AND CHEAPER SOURCE OF FILLERS

Fat grafting or liposculpture means removal of fat from one part of Body & deposit it in other parts of the body to reshape that surface.

Various materials like fat, injectable implant, collagen, hyaluronic acid etc. are used as filler to inject in these wrinkles and frown lines to reduce or to eradicate them. Each material has its advantage & disadvantages. Fat injection is done in persons who have sunken areas on the face, cheeks, thin lips, skin wrinkling area of back side of palm etc. Procedure may need 2-4 hours. Patient feels discomfort, swelling and bruising. He can join his work within 5-10 days. Rarely infection may occur. Side effects are minimum. Fat injection may need repetition3-4 times at the gap of 4-6 months to create permanent effects. After every procedure 30-40% fat remain after 36 months.

Facial fat grafts for recontouring:

Human fat is delicate and fragile substance. Strips of fat are removed from the donor site and inserted in the hollow part, the nasolabial fold (skin fold from the bottom of nose to the corner of the mouth), the marionette line, (that runs from the mouth down the chin), the upper lips, lower lips, cheeks, eye brows and the areas next to the eyes where crow feet appear. Your face is more than any other part of your body. It defines you. You use it to communicate, to be recognized, and to influence other people. So think of changing shape of some part of the face to make it more attractive.

Best Candidate for Facial Implants/ Fat Grafting:

The best candidates for cosmetic surgery are people looking for improvement, not perfection, in the way they look. No man-made substance is perfect.

Microlipo injection or autologous fat transfer is procedure used to recounter the face and to increase prominence of cheeks, chin, lip and lower part below the eyes. Fat injection also helps to improve any contour, depression, fine and deep wrinkle lines, furrows, pits of acne scars. As this is one's own fat, it is not harmful at all and it does not cause any tissue reaction or allergy. If the area where fat is injected is non-movement area, the results are long lasting. e.g. area of grooves under the eyes, sunken cheeks. Lip is highly mobile and so these results are less favorable. So dermal grafts are used for permanent increase volume of the lips. Atrophic aging of the skin on the hands and the breast can also be treated.

Fat is obtained from another part of the body such as lower most part of abdomen, inner aspect of thighs etc. Fat is removed under local anaesthesia or sometimes under general anaesthesia and then injected just under the skin beneath the wrinkles. Injection is repeated till desired correction is achieved. After first few months, 60% fat is reabsorbed. So, three or four re-injections are necessary at a gap of 4- 6 months in most of the persons. Following fat injection, local swelling and some discomfort may develop which soon disappears

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One's own fat is ideal filler substance. The cells are fragile, small. Usually more than needed volume of fat is injected because it is partly absorbed by the body. No bandage is required. In some patients, revision injection is necessary 2-3 times after 6 months to 1 year to maintain fresh appearance of the area. Thus, ugly part of the body (e.g. hand) becomes more attractive.

Benefits: Fat and tissue transplant: *One of most well-tolerated fillers available to aesthetic surgeons. *Natural appearing results. *Long lasting results. *Safe as autogenous fat used-no risk of any reaction Risks in fat and tissue/graft transplant: *Swelling is the most common past-operative side effect. May last for 2-3 weeks. *Bruising in both the donor and recipient area- lasts up to 2 weeks. *Numbness of the skin overlying the donor and injected areas. This is usually temporary. *Under or over correction of the de4fect-may require second procedure. *Infection.

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