When it’s done correctly and done over the entire face or to fill in hollows, it is a permanent filler, said Thomas Tzikas, MD, a private practice otolaryngologist and plastic surgeon in Delray Beach, Fla. I’ve got patients I’ve seen eight to nine years after and they’ve still got the majority of fat in place.
Explore This IssueMay 2006
Advantages, Disadvantages, and What about Hyaluronic Acid?
The greatest advantage of fat grafting is its safety as an autologous product. It’s also less expensive than other injectable fillers such as the hyaluronic acids Restylane and Hylaform.
Fat and Restylane are both good fillers, Dr. Nayak said. Restylane can do some things that fat can’t, like fill finer wrinkles and upper lip lines. However, Restylane is very pricey ($500/cc on average), compared to fat, and lasts four to eight months on average. So, it’s pretty price-prohibitive for someone who needs 15-30 ccs of volume re-expansion in their face.
What I do with fat is use it many times as a whole facial rejuvenation rather than just for filling in labial folds or lips, where it is less effective, Dr. Tzikas said.
Suzan Obagi, MD, Assistant Professor of Dermatology and Director of the Cosmetic Surgery and Skin Health Center at the University of Pittsburgh (Pa.), has worked with fat augmentation for nearly six years. She said that although 80% of her facial rejuvenation patients elect fat grafting over other procedures, the technique should not be used with smokers, due to vascular constriction, or with individuals who take blood thinners, since bleeding may occur in the transfer area, killing the fat. She also has gotten better results with normal weight individuals than people who are extremely thin.
Minimizing Recovery Time
Patient recovery time is another consideration for facial surgeons considering fat grafting. When multiple passes are used to inject fat, swelling and bruising can last from days to a couple of months, depending upon the patient.
When it’s done correctly and done over the entire face or to fill in hollows, it is a permanent filler. – -Thomas Tzikas, MD
A lengthy recovery time is unacceptable to the patients of Richard Ellenbogen, MD, a private practice plastic surgeon at Beverly Hills Body in California. Dr. Ellenbogen is considered by many as the father of modern fat grafting, having developed a procedure called pearl fat grafts in 1986. Over the years he has refined his technique, but he disagrees with Dr. Coleman’s use of multiple passes.