Facial Fat Grafting Miami

Aesthetic procedures involving the eyelids, brows, midface, and other surrounding facial areas are constantly evolving. As we have seen the popularity of facial fillers increase exponentially over the last 2 decades, it has become even more evident how important having significant volume in certain areas of the face is for maintaining a youthful appearance. In general, volume loss in the face tends to be more pronounced in the areas around the eyes, cheeks, temples, mouth, and jawline. For this reason, volume replacement is an integral part of balanced and complete facial rejuvenation. Dr. Lewen frequently performs various procedures to achieve facial volume replacement for his patients, which include: Facial Fat Grafting, facial filler injections, or, in some cases, facial implants.

Facial Fat Grafting is a procedure that involves the removal of a small volume of a patient’s own fat from the abdomen, flank, or thighs, and this fat is then transferred or grafted into various areas of the face where facial volume loss has occurred. Only relatively small volumes of fat are used for this procedure, and so it is not the same as having a liposuction procedure performed for the purposes of body sculpting.

Facial Fat Grafting is a procedure that is frequently performed in combination with other cosmetic surgeries/procedures, such as upper and lower lid blepharoplasty, brow lift, midface lift, face/neck lift, and CO2 laser resurfacing.

In particular, Dr. Lewen regularly uses Facial Fat Grafting to achieve a more balanced and complete rejuvenation of the lower eyelids for certain patients in combination with blepharoplasty surgery. For these patients, an optimal rejuvenation of the lower eyelids cannot be accomplished by just simply removing the bags of fat or pulling the lower eyelid skin tighter. It is important to understand the significance of volume, shape, and positioning of the midface when considering the best rejuvenating options for the lower eyelids. It is this relationship between the lower eyelids and the midface, along with the smoothness of transition between these two areas of the face, that is integral for the best possible cosmetic rejuvenation with natural-appearing results. For this reason, the ideal rejuvenation of the lower eyelids for many patients may necessitate some combination of the following procedures:

  1. Lower eyelid blepharoplasty to sculpt and reposition the fat pockets that may be causing the appearance of “bags” under the eyes.
  2. A re-suspension of the muscle tissue in the lower eyelid, lifting the upper portion of the midface and the transition between the lower eyelid and the midface into a more youthful position.
  3. Tightening the lower eyelids to secure and maintain a youthful and rejuvenated shape to the eyes.
  4. Tightening the skin underneath the eyes to minimize the appearance of wrinkles or folds under the eyes.
  5. Volume replacement in the lower eyelid or midface with Facial Fat Grafting or facial filler injections to create a smoother transition between the lower eyelid and the midface tissues.

For many patients, an ideal, natural-appearing rejuvenation of the lower eyelids is just not possible with just tightening of the lower eyelid skin and/or removing “bags” of fat from the lower eyelid. Although it may seem that this simpler excision of tissue and pulling things tighter is all that needs to be done to improve the appearance of this facial area, this outdated approach to lower lid rejuvenation and blepharoplasty can actually make your eyes appear somewhat more sunken, hollow, and aged in appearance over time. This again highlights the importance of performing volume replacement procedures such as Facial Fat Grafting as an important adjunct to other standard blepharoplasty techniques.

Dr. Lewen’s meticulous fat transfer technique not only addresses the cosmetic portion of the lower eyelid area but also serves to improve lower lid support. In many cases, properly repositioned or grafted fat can reduce the amount of lower eyelid skin that may initially appear to be in excess as this area becomes “re-inflated.” Adequate volume in the midface also helps to maintain a youthful contour of the lower eyelids, and creates a smoother blending effect in the transition between the lower lid and the cheek areas.

To understand the true role of Facial Fat Grafting and volume replacement procedures, it is important to consider the shape of a face as it matures. A child’s face, no matter how thin, tends to have more of a round shape that is attributable to normal fullness from “baby fat.” This baby fat tends to shrink over time, and at different rates depending on individual genetic and environmental factors. By the late 20’s/early 30’s, much of the baby fat in a woman’s face will be gone, and the face will appear more heart-shaped, with fullness still maintained around the eyes and a more tapered jawline. With continued aging, loss of volume around the eyes, in the midface, around the mouth, and along the jawline areas, causes these areas of the face to appear deflated and sag. This also contributes to the appearance of added weight in the lower face, neck, and jowl areas. These age-related facial changes create a longer shape to the face, eventually, the youthful heart or triangular shape tends to appear inverted, with fullness in the lower part of the face and a lack of volume in the upper areas. Although many people want Facial Fat Grafting or other volume replacement procedures such as Facial Fillers to erase lines, folds, and wrinkles on the face, the more important role for these procedures is to restore the youthful balance, contour, and shape to the face. This is extremely important for achieving the most natural and effective facial rejuvenation.

Facial Fat Grafting and other volume restoration procedures also can significantly improve upon shadowing effects that can be more evident in certain facial areas with aging, and can make a face appear brighter. This can also make the overlying skin of the face appear more radiant and youthful.

Facial Fat Grafting is minimally-invasive, and does not require any large incisions to achieve excellent results.

How is it performed?

Dr. Lewen typically performs Facial Fat Grafting/Fat Transfer with the use of a gentle, hand-harvesting method, simple purification process, and an advanced microdroplet injection technique that has shown to improve the durability and survival of fat grafts, as compared to some older methods. Dr. Lewen performs many Facial Fat Grafting procedures in combination with other cosmetic surgeries, such as blepharoplasty. For this reason, IV sedation is typically used for best patient comfort. A tumescent local anesthesia technique will then be used to effectively numb the area for fat harvesting. After the appropriate amount of fat is harvested, Dr. Lewen will carefully transfer the fat into small syringes. He will then inject the fat through a blunt-tipped cannula to add volume to specific areas of facial hollowness. With the use of this microdroplet technique, grafted fat will typically have a better blood supply to help improve the survival of the graft. This also helps to create smoother contours in the final results. You can expect that there will be some level of resorption of the fat graft after it is placed in the hollow areas of your face. For some patients, Dr. Lewen may suggest another Facial Fat Grafting procedure at some point in the future, or he may also suggest adding Facial Filler injections to help fine tune your results.

What is the downtime?

Every patient is somewhat different in terms of the healing time required after a Facial Fat Grafting procedure. Procedures that utilize a higher volume of fat will typically have slightly more healing time required. Although Dr. Lewen utilizes advanced injection techniques to minimize bruising as much as possible, this can still occur with these injections, and you should also expect some degree of swelling in the treated area afterwards. Facial Fat Grafting procedures will commonly have some swelling that can take several weeks to fully settle. The amount of swelling following your procedure is completely patient-dependent, and is very difficult to estimate based on how other patients have responded. Every patient heals a little differently, and it is very important to remember this point throughout your entire recovery period. Applying ice to the treated areas immediately afterwards and for the first 48-72 hours following your procedure will significantly reduce the risk of additional bruising and swelling in the area. Arnica Montana, a homeopathic remedy, may also help to alleviate swelling and bruising somewhat faster. After a Facial Fat Grafting procedure, you should expect to have at least a few weeks of downtime, and it is not recommended to resume normal exercise or physical activity in the immediate post-operative period. Although bruising and swelling may often settle much faster, you should not expect to be fully healed immediately after undergoing this procedure.

If you have any additional questions or concerns about downtime following a Facial Fat Grafting procedure, please contact one of Dr. Lewen’s Patient Coordinators to learn more about what can be done before and after your procedure to ensure that you have as little downtime as possible!