Facial aging is a dynamic process that involves changes in all layers of the face. Yes, the skin loses its elasticity, but the loss of volume from the surface of bony structures, the fat pads, and facial muscles is equally important. Gravity pulls everything down, resulting in folds and jowls that are a tell-tale sign of aging. That’s why fat grafting to specific areas of the face is an essential part of a facelift at my Toledo, Ohio, practice.
In addition to recognizing the importance of restoring volume to create a more youthful appearance, facial rejuvenation techniques have become less invasive. Shorter incisions are now often used without sacrificing the quality of results.
The Evolution of the Facelift
Several decades ago, facelift surgery only addressed loose skin. Surgeons made incisions, removed excess skin, and pulled the remaining skin tighter before suturing the incisions. As facelift techniques evolved, plastic surgeons focused more on lifting and repositioning the tissue and muscle and then carefully re-draping the skin. This technique creates results that appear more natural and avoids the “wind tunnel” look that characterizes “skin-only” lifts.
The most common modern facelift technique is the SMAS facelift, which I often combine with a neck lift. Another technique, called the deep-plane facelift, is more invasive and requires a longer recovery.
Meticulous placement of incisions near the ears, coupled with a skillful technique that avoids pulling the skin too tight, ensures scars are virtually invisible. You might have heard about mini facelifts, or “short-scar” facelifts, but neither of those techniques enables the surgeon to address jowls, loose neck skin, or concerns about nasolabial folds.
The Importance of Fat Grafting
Even though lifting and repositioning the underlying tissue and muscle produces much better results than skin-only facelifts, the technique doesn’t address age-related volume loss. This deep volume loss causes the more superficial layers of skin, muscle, and connective tissues to sag downward (a consequence of gravity) and toward the center of the face, causing the folds and jowls that we start to see in our faces when we advance in years.
Fat grafting offers a long-lasting solution, restoring volume around the eyes, mouth, and temples to restore more of a facial V-shape that’s universally associated with attractive youthfulness.
“Facelifts for me and my patients are not about
creating something that was never there. Patients don’t want to look like they
never looked. They want to look refreshed. With fat grafting, we’re getting
results that look more natural than ever.”
Fat grafting is now a technique commonly used by plastic surgeons performing any kind of facial rejuvenation surgery. A random survey of members of the American Society of Plastic Surgeons conducted a few years ago found that 85% of the surgeons used fat grafting for facelift patients.
One of the main sites of fat injection was the cheek (malar) area, where fat grafts are used to counteract age-related deflation to provide a fuller, more rounded appearance of the cheeks. The area below the lower eyelids and the nasolabial folds between the nose and the corners of the mouth were also common sites for fat grafting.
How Is Fat Grafting Performed?
Sometimes called fat transfer, fat grafting is a technique that’s been used in cosmetic surgery for decades. Besides using it to enhance the results of facelift surgery, plastic surgeons also use fat transfer techniques to augment buttocks and for some breast augmentation patients.
The fat grafting process involves 3 steps:
- Harvesting fat using liposuction
- Purifying the fat by spinning it in a centrifuge
- Re-injecting the purified fat to restore facial volume
Typically, fat is taken from the abdomen, thighs, or buttocks for transferring. Not all fat cells survive the transfer process, so I inject slightly more than is needed to ensure I’ve added enough volume to produce the desired results. That means some patients will notice their faces look very full during the recovery. That’s common as the fat cells integrate with the surrounding tissue.
Unlike injectable fillers, which need to be re-administered at regular intervals to maintain the results, facial fat transfer provides outcomes that can last for many, many years. However, patients should keep in mind that fat cells transferred to the face can swell or shrink in the same way fat cells in other areas do. For this reason, it is critical that patients are committed to maintaining a healthy, stable weight after a facelift with fat transfer in order to preserve the results of their fat injections.
Results Tell the Story
Looking at before-and-after photos reveals the truly transformative outcomes for patients who get facelift and fat grafting. Take a look at these before and after photos of patients who’ve had the combined procedures and look more rested and youthful.
Schedule a Consultation
As one of the best plastic surgeons in Toledo, Ohio, Dr. Colville is in high demand for women and men considering facelift surgery. To learn more about his experience and training and whether you can benefit from facial rejuvenation surgery, request a consultation using the online form to meet with him personally. Or call our practice at (419) 534-6551 to schedule an appointment.