Fat Transfer

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Facelift by by Dr. BCK Patel MD, FRCS in Salt Lake City and St. George, Utah

WHAT IS FAT TRANSFER?

Facial aging is a three-dimensional change: looking at our appearance and photos from younger days, the smooth (and relatively full) contours impart a youthful appearance. Contrary to previous beliefs, it is not only the skin that ages, but also the deeper structures including the fatty layer, the muscles, the fascia and the bones! The modern aesthetic surgeon addresses all of these layers. To that end, one can create such fullness and smoother contours with implants, but also with fillers and fat. Although fat grafts have been performed for many decades, it is only recently that we have techniques that allow finesse and longevity to fat grafts, without the “over-filled” appearance. 
Orbital fat atrophy showing deep superior sulci ina female Dr. BCK Patel MD, FRCS
Left facial atrophy
Progressive fat atrophy Dr. BCK Patel MD, FRCS

AM I A CANDIDATE FOR FAT TRANSFER?

Fat grafts are often used in reconstructive as well as cosmetic cases. There is evidence that not only does fat grafting create fullness, but it also improves the texture of skin. Therefore, fat grafting is almost routinely use in facelift surgery. Furthermore, fat grafting improves the more acute lines of transition (nasolabial folds, melolabial folds, lower eyelid grooves, frown lines, etc) on the face. Depressions caused by animation or scarring can be improved. Even the fullness that we have under our brows decreases with age, giving us a more skeletonized look: fat grafting here restores the firmness and curvature of youth. So you may well be a candidate for fat transfer.
Beautiful facelift and neck lift results by Dr. BCK Patel MD, FRCS of Salt Lake City and St. George
Beautiful facelift and neck lift results by Dr. BCK Patel MD, FRCS of Salt Lake City and St. George fat grafts to the face
Beautiful before and after facelift results by Dr. BCK Patel MD, FRCS
Beautiful facelift and neck lift results by Dr. BCK Patel MD, FRCS of Salt Lake City and St. George fat grafts to the face
Beautiful facelift and neck lift results by Dr. BCK Patel MD, FRCS of Salt Lake City and St. George fat grafts to the face

HOW WILL I BE ASSESSED?

A review of photographs from younger days allows one to see the changes, not only in terms of descent, but also the loss of fullness. Depending you’re your concerns and the procedures being contemplated, attention will be paid to give you the lifting, tightening and filling that many faces benefit from. It is impossible to accurately impart exactly the results one is hoping for, but an overall improvement can be aimed for and predicted based upon experience. Assessment of particular areas or the whole face allows one to predict where and how much fat may be needed.

 
Beautiful facelift and neck lift results by Dr. BCK Patel MD, FRCS of Salt Lake City and St. George fat grafts to the face
Beautiful facelift and neck lift results by Dr. BCK Patel MD, FRCS of Salt Lake City and St. George fat grafts to the face
Beautiful facelift and neck lift results by Dr. BCK Patel MD, FRCS of Salt Lake City and St. George fat grafts to the face
Beautiful facelift and neck lift results by Dr. BCK Patel MD, FRCS of Salt Lake City and St. George fat grafts to the face

HOW IS A FAT GRAFTING PERFORMED?

It may safely be stated that almost everyone has an area (or two) where the loss of some fat would not be a great inconvenience. To that end, and also depending upon some other factors, a site or sites may be chosen from where fat is harvested.
The very basics of fat grfting involve:

  1. Small incisions at the donor site (around the umbilicus, for example) to allow infusion of tumescent fluid (this fluid reduces bruising and also provides anesthesia).
  2. Fat is obtained and prepared by removing blood products.
  3. Transfer of fat is performed with small cannulae and small incisions.
  4. The incisions are closed with dissolving sutures.
Liposuction and nano fatgrafts by Dr. BCK Patel MD, FRCS

WILL THE BODY NOT ABSORB THE TRANSFERRED FAT?

There has been much debate and discussion in plastic surgery about the survival of fat and how more of it may be made to survive. To that end, using the latest techniques of atraumatic harvesting and transfer of fat, we can now confidently state that at least 50% of the transferred fat will survive. Certainly, in the beginning the fat grafting together with the attendant swelling can make the grafted areas look “over-filled”. Once the swelling settles and the proportion of fat absorption occurs, it is rare to look “overfull.”

​Some patients may need further fat grafting in certain areas, although this is usually combined with any other surgical procedures that the patient may undergo.
 
Liposuction and nano fatgrafts by Dr. BCK Patel MD, FRCS
Liposuction and nano fatgrafts by Dr. BCK Patel MD, FRCS fat grafts to the hands
CO2 laser to the face and also a hammock lift in a female giving beautiful results by Dr. BCK Patel MD, FRCS
“Well, the last time I had a picture taken I could hardly see my eyes because of the weight of heavy eyelid. Then I paid attention to how I was actually using my eyes and I really noticed when I was looking at anything especially the computer I was straining my forehead to see better. Since I have had it done I no longer have to lift the forehead and tilt my head to see. It is amazing! I love…”  D. Rock  63 Yrs Old with Fat Droopy Eyes – Salt Lake City, UT

WHAT HAPPENS IF I PUT ON WEIGHT AFTER MY FAT GRAFTS?

There was a tendency to perform large volume fat grafts to the face without any surgical procedures: the thinking was that replenishing the volume loss that occurs with age gives a pleasing fullness to the face. This is certainly the case: judiciously performed facial fat grafting can give excellent results. However, we soon noticed that if the patient puts on weight, the fat grafts also expand!

​When small quantities are used to create filling and fullness, this does not, usually, create problems. But with the large volume fat grafts, we see “full, round faces” after weight gain, which may not have many wrinkles or hollows, but are not exactly pleasing. 

WHAT OTHER PROCEDURES MAY BE PERFORMED WITH FAT GRAFTS?

It is more the other way round. “Which procedures benefit from concurrent fat grafting?” Fat grafting may be conserned with a wide range of reconstructive and cosmetic procedures. Most cosmetic procedures now have some component of fat or tissue transfer to achieve a balanced appearance. 

liplift-and-fat-grafts_orig
CO2 laser to the face to improve skin color, tone and wrinkles in a female by Dr. BCK Patel MD, FRCS Patient also had a hammock lift

WHAT ARE THE ADVANTAGES OF FAT GRAFTS?

Fat grafts to the hands BCK Patel MD, FRCS
CO2 laser used with the Hammock Lift by Dr. BCK Patel MD FRCS in a female giving a beautiful result

Using one’s own fat allows for better and longer-lasting survival. Also, it reduces the need for fillers in the futures and this can reduce the cost of fillers. It is not uncommon to get a safe level of filling with fat and then augment the depressions and volume loss with fillers which can be used without surgery and done safely in the clinic. Fat grafts also improve the texture and appearance of the skin overlying the fat grafts. There is much debate and discussion about why this might be the case. Finally, it is your own material, so risks of rejection and infection are minimal.

WHAT KIND OF RESULTS CAN I EXPECT AFTER FAT GRAFTING?

Fat grafts to the hands BCK Patel MD, FRCS
Initial swelling may make the injected sites look “overfilled”. However, this settles quickly. The best way to assess the results is to compare side-by-side photographs before and after the procedures. Two dimensional photographs may not adequately convey the full benefit of fat grafts, however. 
 

BEFORE & AFTER

CO2 laser to the face to improve skin color, tone and wrinkles in a female by Dr. BCK Patel MD, FRCS Patient also had a hammock lift
Hammock Lift by Dr. BCK Patel MD FRCS in a female giving a beautiful result
“I had a excellent eye lift done by Dr. Patel. He knows what he is doing and is very pleasant. Dr.Patel was easy to get an appointment and he works with you. The office staff was very pleasant and made you feel calm.”  D. Gull Highly recommended for eye lift surgery – Salt Lake City, UT

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FAQs

Facelifts are performed in an operating theatre for the sake of sterility and your comfort. We have a team of anesthesiologists and nurses who are trained to specifically look after patients undergoing these procedures.
 
 
General anesthesia is best for facelifts, although in some instances, sedation anesthesia may also be used.
 

With a 3-D procedure, there are several layer of sutures, accurately placed to give the lifting, tightening and filling, without leaving any tell-tale pull-lines. Some are slow dissolving sutures, others are more permanent. The skin sutures are generally removed between 7 and 14 days. ​

Lasers will be used to treat peri-oral lines, “sleep lines” on the cheeks and other skin irregularities. The advantage of using all the skills and modalities available to us, rather than performing quick or weekend or one-hour facelifts is that it allows us to give you a remarkable improvement not only in the structure and appearance of the face, but also the health and smoothness of the skin as seen here:
 
Facelift surgery can take between 3 and 5 hours of surgery time, depending upon the planned procedures, patient’s face-type, age and other factors. ​
 
Bruising and swelling are de rigeur! However, significant long-lasting complications are rare.
Bleeding is not common as we pay close attention to proper hemostasis. On rare occasions, a small hematoma may collect.
​
Everyone will experience some numbness in the face: this resolves over weeks to months. This occurs because of the dissection of the face. This is not a complication.
Because of the dissection and repositioning of the tissues, it is common for there to be small differences in the smile between the right and left sides: this is usually only noticeable to the patient and to Dr. Patel! It recovers over a few weeks.

All faces have asymmetry and there will be some degree of asymmetry. This is to be expected.
Permanent weakness of nerves and muscles is rare.
The scars are usually very well hidden. However, some patients may have a tendency to cause hypertrophic scarring: in such cases, certain lasers and treatments will help. By-and-large, scars are rarely a problem. With Caucasian skin, pinkness of scars is to be expected for several weeks. With darker skin, some hyperpigmentation may occur. 
 
Bruising around the jawline and upper neck is common for the first two weeks. The face itself usually will not get much bruising, but may be pink from any laser work. Swelling is to be expected because of the extent of the surgery: the swelling abates over about two weeks. ​
 
Only if insurance will buy you a Rolls Royce (Phantom, of course). ​
 
A sensation of firmness will be there because of the swelling: this is present for the first few days. Most patients do not need prescription pain medication after the first two to three days. ​
 
We will provide you with a special neck dressing which you will wear as much as you can for the first couple of weeks. You will also apply a moisturizer (any brand will do) to the face as healing skin and lasered skin requires moisturizer. Icing the face also helps for the first two to three days. Many of our patients will ice the face for longer as it feels good. You may be up-and-about the day after surgery. Gentle exercise (treadmill and stationary bicycle) may be commenced by day 3. More vigorous exercise like skiing and tennis may be resumed by about day 10. ​
 
Ideally, you should be within about 3 – 5 pounds of your desired weight. Whereas I can create the most beautiful angles and curves in slim patients, if you are able to get close to your ideal weight, we can wonders as can be seen in this patient who lost some weight before her surgery and is absolutely chuffed at her result:
 

In the first few days, everyone will experience some degree of dryness and blurry vision. You will also feel that your lids look a little tight on the outer corner where you will also feel some of the deeper sutures if you put your finger there: this is of no concern. The tightness and the bumps under the skin settle over a few weeks.
More serious complications which are very rare include excessive bleeding, hemorrhage and loss of vision. 

BROWSE TREATMENTS

Browlift
Lower Blepharoplasty
Midface Lift
Lip Lines
Skin Resurfacing

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    Contact Info

    ​Dr. BCK Patel MD, FRCS
    ​1025E 3300S
    Salt Lake City, Utah 84106, USA

    (801) 413-3599 (phone/text)
    E-Mail: bckpatelmd@gmail.com
    bckpatel.info

    Dr. BCK Patel MD, FRCS
    617 E Riverside Dr Suite 101
    ​Saint George, UT 84790, USA
    (435) 215-0014
    ​E: drbckpatel@gmail.com

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