Fat grafting: The missing link

Fat grafting is an important part of the cosmetic surgeon’s facial rejuvenating arsenal — it allows treatment of age-associated loss of facial volume not addressed by facelift surgery, according to San Francisco-based plastic surgeon Timothy Marten, M.D.

“Abundant clinical and scientific evidence exists confirming that fat grafting produces a persistent and worthwhile improvement,” Dr. Marten, founder and director of the Marten Clinic of Plastic Surgery. Fat grafting, he says, is an artistically powerful adjunct to a facelift that provides a more healthy, fit, youthful, sculptural and sensual appearance than facelift, alone.

“Fat grafting is often more important to rejuvenating the secondary facelift patient than the facelift, itself. These benefits may offset the drawbacks of increased operating time, some uncertainty of graft take and a longer period of recovery,” he says.

Dr. Marten, who presented on the topic of fat grafting yesterday during the Vegas Cosmetic Surgery and Aesthetic Dermatology 2016 meeting in Las Vegas, says traditional procedures to rejuvenate the face relied on skin resurfacing and, or, “lifting” ptotic facial tissues but did not address facial hollowing and atrophy, which are now understood to be important parts of the aging process. These, according to the plastic surgeon, are increasingly recognized as missing links in facial rejuvenation.

“Fat grafting allows us to treat atrophy (something we could not do in the past) and provides for a more comprehensive treatment of aging change,” he says. “And unlike temporary fillers, fat grafting results in an enduring change and an arguably more natural appearance as grafted [fat] actually integrates with facial tissues.”

Dr. Marten offers these 10 tips for getting started with fat grafting:

1. Acknowledge atrophy as a part of the aging change of the face and learn to recognize it.
2. Set aside unfounded fears perpetuated by those who don’t understand the need for the procedure or who are unwilling to take the time to learn it and do it.
3. Learn the basics of the fat grafting technique.
4. Obtain the needed equipment to properly harvest, process and inject fat.
5. Accept that fat grafting is a tool — not a guaranteed path to success. It will only be beneficial if carried out carefully and correctly.
6. Make the needed commitment of time in the operating room to properly perform the procedure.
7. Don’t underestimate the procedure’s technical and artistic difficulty.
8. Recognize that without artistic vision there can be technical successes that are aesthetic failures.
9. Make small additions at first to gain familiarity with the technique. Starting out conservatively will mean that problems, should they occur, will be minor and easily managed.
10. Follow up patients closely, critically analyze outcomes and find a way to do the next case better.

“Fat grafting comprises volumetric rejuvenation--not tissue tightening,” Dr. Marten says. “It’s autologous, produces a long lasting and sustained improvement, and, in addition, provides a ‘stem cell’ regenerative effect. For the first time, we may be truly rejuvenating tissue; not merely creating an illusion of it.”

Disclosure: none