Fat Grafting: A Natural Alternative to Fillers

Wednesday, February 7, 2018

As we age, we all notice more laxity of tissues in the face and neck. What makes it more pronounced is the associated deflation or loss of volume most of us experience with the aging process. Sun exposure, smoking, weight fluctuations and poor sleeping and eating habits all make this process worse.

What makes our children look so youthful is well supported tissues and nice full cheeks. Although, unfortunately, we can’t reverse the aging process, we can make people look more refreshed and youthful by simply adding volume to the face. There are many fillers on the market for this purpose. They can broadly be divided into three types:

  • Those that are temporary. The most popular here are Juvederm and Restylane which are variations of hyaluronic acid that is normally found in the skin. They are safe, reliable and effective but do go away, sometimes as quickly as a few months depending where they are injected (3-6 months for lips, 6-12 months for cheeks and 12-36 months for nose).
  • Those that are permanent or long-term such as Radiesse. These are all foreign materials not normally found in the skin. They all run a risk of infection or adverse reaction even many months after injection. They are most suitable for thick skin areas such as cheeks or folds between the cheeks and upper lip.
  • Those that incite a response from the body on purpose. Here, Sculptra is best known. It causes the body to lay down collagen over a series of injections. Some people can form granulomas or nodules in response to this injection so it is limited to thicker areas that can hide such nodules from visibility.

The ideal filler is one that is safe, natural, stay long term and has no risk of foreign material response or rejection. Fat is the only one that fulfills this ideal. We generally suction it through the belly button to avoid scarring that is visible. It is then spun in a centrifuge to separate the “good fat” from the fatty acids (cause it to resorb) and the local anesthetic (would just resorb). It is then inserted with cannulas as for any filler. As it is naturally found in the skin, it can be injected all over the face including lips, cheeks, and forehead.

Generally, we do this under anesthesia, as it is more comfortable for the patient. The drawback of this technique is the significant swelling that people develop after injection. Generally, much of it is resolved by one week after the procedure. 80% of people will retain most or all of the fat that is injected meaning, it stays there long-term. 20% resorb it and no one is sure why or how to predict who will resorb it. Even in patients that resorb it however, they still have improvement for often many months making it a natural alternative to resorbable fillers. Simply injecting fat that is liposuctioned does not seem to work well as the fat has been traumatized by the suction process. We only use gently hand suction with little pressure to remove the fat cells for grafting.

Finally, fat grafting has an advantage over all other fillers in that, with the fat, we are also transplanting stem cells. Thus, many patients observe the skin overlying the area of injection to appear healthier and better and not just plumped up as with all other fillers.

Dr. Ducic has authored a number of publications on fat grafting and has performed this procedure for the past 20 years with great success. He looks forward to visiting with you to discuss this and any other facial cosmetic needs you may have at convenient offices in Colleyville (817-503-2442) and Fort Worth (817-920-0484).