by Tim Neavin, MD
Fat grafting is when fat is taken from an unwanted area of the body, such as the love handles, then injected into an area where volume is deficient.
The series of photographs show what I call “subtle but significant” changes to face architecture.
While many dermatologists and plastic surgeons place a heavy emphasis on “wrinkle” reduction to restore youth with Botox and skin peels, my approach is a bit different.
While I agree that erasing or minimizing crow’s feet or transverse wrinkles in the forehead or the “11s” above the nose makes on look “better”, the most important thing we can do to rejuvenate the face is to restore its architecture.
So the next question you may be wondering is, “What is a youthful facial architecture?”. For one, the face should be balanced, and the topic of facial balancing can be a subject of a dozen textbooks. But to make it simple, the face from top to bottom should be divided into thirds: Hairline to bridge of nose, bridge of nose to mouth, and mouth to chin. From left to right, the face can be divided into fifths. Cheek bone to outer eye, eye aperture, between eyes, other eye aperture and other outer eye to cheek bone. That’s the basics.
What happens with age? And what if we reduce all the wrinkles of a 35 year old (as in this picture)? Why do they not look younger simply with wrinkle reduction?
Top Heavy Faces are Youthful
Because the architecture is not consistent with a face of youth. The face of youth is TOP HEAVY. I’ve used this word in many blogs. The young face also has very few SHADOWS. Thus, targeting facial youth relies on restoring the top heavy face of youth and eliminating the shadows of aging with volume addition such as fat grafting. The upper third of the face us WIDENED, and the shadows are FILLED.
Above, 36 cc of fat was injected into the regions highlighted in blue. 36 cc of fat, by the way is about 36 syringes of Juvederm®. At 650 dollars a syringe, this type of volume enhancement with hyaluronic acid products like Juvderm®, Restylane®, or Radiesse® (no-hyaluronic acid product) can be quite expensive.
While 36 cc of fat was injected, probably half (18) off cc actually “took”, which is a reasonable “take” for fat grafting. That is, I tend to over-correct with fat grafting because I know not every cell will survive. But the results from facial remodeling are striking and appear natural and long lasting.