Aging of facial tissues is much more complex than the simple downward pull of gravity. Unfortunately, most plastic surgeons treat only this single factor and, in so doing, change overall facial esthetics. This is the mistake that creates the stereotyped “windtunnel” appearance of the classic facelift, and gives people the justified fear of the “pulled” look and bony, skeletal appearance. Why does this happen?

Other changes to the face are occurring over time, which are equally as important as the pull of gravity. The most important is loss of fat, that “baby fat” softness that gives the attractive look of youth. As our faces become thinner as we grow older, tissues sag even more, the way clothes become loose when we diet. To correct this by pulling does not restore the face to the look of youth. It changes the way we look and creates the look of unnatural, tight plastic surgery.

The vast majority of patients don’t want to look different. They just want to look as they did when they were younger. This cannot be achieved without the replacement of this structural fat layer into the face as the keystone to facial rejuvenation. The most affected location is around the mouth- in the deep fold between the nose and the mouth, in the downturned corner of the mouth (“unhappy triangle”), and the lips. All become thinner and more severe with age, and cannot be improved by classic “pulling.” In fact, pulling makes everything worse by distorting the very structures we are trying to make more youthful.

Pulling skin creates plastic people. Replacing lost baby fat tightens and rejuvenates the skin and deep tissues. Many aging faces require both, but it is extremely rare for me to perform a facelift without also performing fat grafting at the same time. It’s that important.

URBAN MYTH #1: Fat grafting isn't permanent
Fat grafting is a bit like playing the piano. If it’s not done well, don’t blame the piano. Fat grafting is the process of taking a person’s own fat and moving it to a different location, where it lives and thrives permanently as if it were there from the beginning. How can this be? We do it all the time- hair transplants for baldness, skin grafts for burns, bone grafts for spinal fusions. All these are examples of where a person’s own tissue can be carefully moved to a different location of their body where it lives safely and permanently. The success depends on the skill and experience of the surgeon. I have been performing this procedure for over fifteen years, in thousands of individuals, with consistently good results. Many expert plastic surgeons from all over the world have written excellent articles on their techniques and success. Many are documented in beautiful photographic layouts in this section. Other even more extensive archives are available for review on request.

URBAN MYTH #2: Fat grafting is a complicated surgery
Transferring fat from one part of the body to another is one of the most simple, safe, controllable procedures in the field of plastic surgery. It’s more of a procedure than an operation. There is no cutting, stitches or scars. The fat is removed through a small, rounded tip instrument that is very gentle to tissues as it extracts the fat, and is injected in a similar fashion. It is what I call “Robin Hood” surgery: it “takes from the rich and gives to the poor.” Where the fat is removed, the area gets flatter and thinner; where the fat is placed, the area gets tighter and rejuvenated. It’s a win/win situation for both locations!

MORAL OF THE STORY: IF WE CAN PUT THINGS BACK WHERE THEY WERE IN YOUTH, AND REPLACE THE THINGS THAT ARE LOST WITH AGE, WE HAVE THE BEST OPPORTUNITY TO LOOK THE WAY WE REMEMBER OURSELVES WHEN WE WERE HAPPY WITH OUR APPEARANCE.
I HOPE YOU ENJOY THE ATTACHED PHOTOS OF FAT GRAFTING AND FAT TRANSFER.