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 hand, with refined 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, fat grafting techniques did not start to spread to the world until about 15 years ago, when it started to go viral.
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 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 a much-desired “Double Ogee” structure on the face, when looked at a 45-degree angle.
Temples are usually full when young. With aging, the temporal fat pad is atrophic, so is the temporalis muscle. Consequently, 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 defects are safely sculpted with fine and nano fat/LipoGems fat.
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. As a rule of thumb, grafting of fat is usually not done in the lower part of the cheek (below the level of the mouth corner) to avoid a simian look.
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. However, it is usually necessary not to chase after the lower portion of this fold, to avoid forcing the lateral aspect of the upper lip down (too long).
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 columella show (veiling) when it is 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, and the absorption is minimal.
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 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 becomes thin, and the underlying tissue disappears. At times, the hands could easily be 20 years older than a person’s face. Luckily, fat grafting could easily solve the problem.
The procedure is usually done with local anesthesia. Our patients think the associated pain is even less than that from a regular 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.