FAT GRAFTING

Fat Grafting In General

Fat grafting was invented almost a hundred years ago, but it is about 25 years ago that it began to be accepted by the plastic surgery society, through the effort of Dr. Sydney Coleman, a Board Certified Plastic Surgeon based in New York City. The beauty of fat grafting is that fat is own tissue. Therefore, there is no rejection. And the patient can pick and choose areas to be sculpted. And in an experienced plastic surgeon’s hands, with great artistic sense, great results are almost always warranted, unless the patient does not have any descent fat to begin with. You are encouraged to spend a good amount of time to talk to your surgeon, show your doctor pictures of yourself when young. Our doctor will make sure that everybody sees a younger and more beautiful version of himself or herself, rather than a face being turned into other people.Despite the steady progress made by Dr. Coleman, the fat grafting techniques did not start to spread to the world until about 10 years ago, when it started to go viral.

SNIF, Micro Fat, and NANO Fat

Over the past few years, science has pushed fat grafting much further. Now we have in place a series of SNIF (sharp needle intradermal fat grafting) procedures that could utilize fine needles for the delivery of regenerative rich micronized fat cells just under the skin. These SNIFs include Micro fat, which could be delivered using a 27 (0.3mm, the size for filler injection) gauge needle, and NANO fat, using a 30 gauge (0.2mm, the size for Botox® injection ) needle. Now, this is revolutionary, because no knife cutting is necessary, neither is a traditional fat grafting cannula required. Because the tiny needles used are so small, the needle marks typically disappear in a mere few days!

Face Fat Grafting

Face fat grafting is essentially sculpturing of the face with a material more difficult to handle than those used by artists. To the least, it is safe to say that not all licensed doctors are good sculptors. This is similar to the situation where if you ask one hundred random painters to sculpt a statue, no more than five would be able to come up with worthy final products. In other words, if you want to have a good facial sculpturing result by fat grafting, you better find a great artist, for even minor mistakes might damage the final result, turning an art work into a disaster. And here we are talking about your face… From prepping the patients, to the final fat grafting, there are more than ten steps that could create caveats. Dr. Yu utilizes harvested fat (from tummy, thighs and any other parts where fat is abundant) with minimal trauma using specialized instruments. Dr. Yu divides fat into coarse fat, fine fat, LipoGems fat and Nano fat, and different fat is utilized in different anatomical areas for different purposes. To warrant great, stable results, even his OR technicians are almost always the same person, specifically trained for the procedure.

Forehead

Coarse/thick fat is used for the deeper loose connective tissue layer, while fine fat is for the subcutaneous and the muscle layer. The mid-forehead depression is filled up to just enough, so is the outer/lateral portion where depression is often seen. Mid-forehead bossing with a flat brow ridge structure, fashioned by many plastic surgeons in Korea, Japan and China is a taboo in Dr. Yu’s practice. The bossing (prominent, round and protruding forehead) not only makes a person look like a new species, but also completely destroys the harmonious coordination of all the surrounding structures, including the eyes, nose, brows and forehead.

Brow Ridges

 

 

 

Brow ridges are augmented with coarse fat, but the periphery is finished with fine fat for a good feathering effect. This, in conjunction with temple fat grafting, helps to create the perfect upper portion of a much desired double Ogee structure on the face, when looked at a 45-degree angle. 

Temples

 

 

Temples are usually full when young. With aging, the temporal fat pad is atrophic, so is the temporalis muscle. So the fat grafting/sculpturing here is to make sure that fat is grafted not only in the superficial subcutaneous layer and the layer below the superficial temporal facial, but also into the deeper muscle structures. For more severe hollowness, at least three entry points are made, utilizing crisscross patterns for a 3-D structured fat grafting, to obtain a satisfying result. 

Tear Trough

 

 

 

Tear trough defects are safely sculpted with fine and nano fat/LipoGems fat. 

Apple cheek

 

 

 

Apple cheek is created into a perfect form by applying good judgement on the aesthetic measurements, thus the lower portion of the double Ogee is created in a satisfactory form.

Nasolabial Fold

 

 

 

Nasolabial fold is grafted with both fine and coarse fat. There is no need to worry about over filling this area, due to the fact that not much fat could survive in this highly mobile region.

Nose Fat Grafting

Nose fat grafting can be employed to correct minor defects of the nose, such as the radix region or a minor saddle back nose. Sometimes it could also be utilized to correct the columela show (veiling) when its mild. Nose fat grafting plays a heavy role in Dr. Yu’s hands, because he utilizes fat grafting to sculpture the nose, brow and forehead structures to provide his patients the looks that only “Cover Girls” could enjoy in the past. 

Alloderm is also becoming more and more popular in nose jobs, especially for minor defect corrections, because it is readily available.

Lip Fat Grafting

If the upper lip is thin, with a gummy smile appearance, fat grafting into the upper lips, canine fossa and the medial cheek regions not only improves the lip aesthetics, but also effectively relives the gummy smile. Again, combination of variously sized fat helps to further increase the survival rate of the fat. Hence, the final result is also better.

Chin Fat Grafting

The chin could be augmented all around, better than any chin implant, except for the severe chin deficiency cases, in which a chin implant may be added. Along with the chin, the lower lip could also be enhanced with fine fat grafting.

Hand Fat Grafting

When people age, the skin thins and the underlying tissue disappears. At times, the hands could easily be 20 years younger than a person’s face. Luckily, fat grafting could easily solve the problem. Because fat tissue contains lots of regenerative cells, the grafted fat not only restores the volume of the hands, but also rejuvenates the hand skin inside and out!

The procedure could easily be done with a local anesthesia. Our patients think the associated pain is even less than a regular poke from an IV insertion, making an IV sedation or general anesthesia completely unnecessary.

"O" leg (Bowleggedness) Fat Grafting

 

Our doctor has done quite a few fat grafting to correct “O” legs, helping patients to avoid the more involved and much dreaded orthopedic surgeries.

"Funnel chest" Fat Grafting

 

If you think your chest has “funnel” deformity and is embarrassing, you could have fat grafting done to get rid of the problem. It is much easier with fat grafting. 

Knee Joint Fat Grafting

Many people experience joint pain, especially in the knee joints. Some may need to undergo joint surgeries, when the symptoms are severe. It is now proven that fat cells could heal the degenerative arthritis of the knee joints. Our doctor utilizes the “LipoGems” purifying system to process a small amount of harvested fat and then inject the resulting regenerative cell enriched fine fat into the knees to cure the knee joint degenerative arthritis. He has done it for three years and the effect to date is amazing.

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