Facial Fat Transfer

Facial aging not only consists of tissue descent and skin laxity, but also loss of fat volume. These changes are commonly appreciated in the areas of the temple, cheek, and nasolabial  region; thus, causing loss of definition of the cheeks and accentuating facial folds. Loss of facial volume can be treated non-surgically or surgically. Non-surgical interventions involve facial filler injection, such as hyaluronic acids. The benefit of this treatment is that it can be quickly performed in the office. The disadvantage of facial fillers is that they are not permanent, and it can become very expensive for patients requiring significant volume restoration. An alternative to filler injections is facial fat transfer. It is a minimally invasive procedure where your own fat is used to restore facial volume. The advantage of this technique is that it can provide permanent volumization and it is cost-effective. 

  • Length of Surgery: 30 minutes -1 hour 
  • Anesthesia: Local, Sedation or General Anesthesia
  • Outpatient vs Inpatient: Outpatient
  • Recovery Time: 5-7 days 
  • Ancillary Procedures: facelift, necklift, eyelid surgery, browlift, skin resurfacing

Dr. Couto is a Cleveland Clinic trained plastic surgeon, and one of the few plastic surgeons in Latin America to have completed an American Society of Aesthetic Plastic Surgeon (ASAPS) endorsed subspecialty training in Aesthetic Surgery and Medicine.  

During his training, Dr. Couto had the privilege to have mentors that are considered top leaders in the field of facial aesthetic surgery. This includes, Dr. James E. Zins, one the largest contributors to the field of facial aesthetics. Furthermore, because of his strong passion for facial rejuvenation, Dr. Couto has co-authored multiple scientific articles and book chapters about facial aesthetics.  Furthermore, Dr. Couto has been an invited faculty member of the annual American Society Plastic Surgery (ASPS) face and neck rejuvenation course.

Facial fat transfer is a permanent therapeutic modality used to treat loss of volume commonly associated with facial aging.  Fat harvested from the abdomen or thighs is injected in those areas of the face mostly affected. Although this procedure can be performed as an isolated procedure, it is typically performed in combination with other facial rejuvenation procedures, such as facelift. It is important to note that fat grafting is not a substitute for facelift procedure.

Individuals exhibiting facial aging changes associated with fat volume loss. These findings include poor definition of the cheeks and accentuated facial folds.

The consultation is divided into five parts: 

  1. Health and Medical History Evaluation

A comprehensive evaluation of your medical history is performed. During this part of the consultation, we focus on identifying any potential risk factors for the surgery. It is important to tell Dr. Couto if you utilize any nicotine products (e.g cigarette, nicotine patch, vape, etc), if you have uncontrolled high blood sugar levels (e.g. diabetes) or if you take any medications, supplements, or other drugs as these can have a big impact on your surgery. An example is aspirin or blood thinners, which can lead to the formation of a hematoma after your procedure. These are common risk factors that can be easily modified with lifestyle changes and can affect your surgical results. Although this procedure is low risk, your health and safety will always be our main priority. We like to set the patient for success, not for failure; therefore, modifying any potential risks is essential to obtain the best possible result.

2) Discuss with the Patient About Surgical Goals

Dr. Couto has a deep discussion with the patient to learn about their concerns and goals. Listening to their interest is crucial, since it is our priority to determine if we can meet their expectations. We focus on learning whether the patient is particularly interested in addressing an specific area of the face or if the patient is interested in a face and neck rejuvenation. 

3) Physical Exam 

Dr. Couto treats the face and neck as a whole, not by areas. Therefore, a systematic analysis of the face and neck is performed. A youthful appearance is marked by smooth transitions between different areas of the face and neck. As a result, Dr. Couto not only examines the regions the patient is mainly concerned with, but also those surrounding areas and structures of the face and neck that could help achieve a balanced and refreshing look.

4) Recommendations & Surgical Plan

Following the physical exam, Dr. Couto develops a personalized surgical plan aimed to meet the patient’s expectations, achieve optimal aesthetic results, and maximize patient safety.  During this time, Dr. Couto discusses with the patient the indicated surgical techniques and explains in detail everything pertaining to the procedure and its recovery.

5) Pricing and Scheduling Information

Once the evaluation has been completed, our team will provide an individualized price quote that is tailored to the procedure(s) discussed during the consultation and review the steps involved in booking the procedure with us.

 

This procedure consists of two parts: fat harvesting and fat transfer. Fat is harvested from the abdomen or thighs using liposuction (yperlink) techniques. Once the fat is harvested, it is cleaned and processed. This ensures that the fat being used is of utmost quality. Then we proceed to do the fat transfer. Using specialized fat grafting cannulas, the harvested fat is injected in a gradual amount in those areas most affected by volume loss. Although fat transfer can be performed as an isolated procedure, it is typically performed in combination with facelift and eyelid surgery.

Several weeks before the procedure, a preoperative appointment will be scheduled. During this appointment, we will discuss the surgical plan again, and clarify any questions involving the surgery. Furthermore, we will thoroughly review with the patient the preoperative/postoperative instructions and medication regimen and schedule your future post-operative appointments.

We always emphasize to our patients that medication (e.g. aspirin, ibuprofen), vitamins and herbal supplements (e.g. Fish oil, Omega-3, Garlic or Tumeric pills, Ginko Biloba) should be stopped at least 3 weeks before surgery, as this increases the risk of bleeding. Furthermore, we remind them that smoking, vaping, or using any nicotine products will affect the results and recovery. There are significant scientific evidence that patient actively using of nicotine (eg. cigarettes, vaping, chewing, etc) have 12 times higher risk of complications following facelift surgery when compared to non-smoker patients (reference). Nicotine affects a person’s capacity for healing; thus, affecting your wounds and scars. During the initial consultation, Dr. Couto will ask the patient to stop smoking at least 4 weeks before the operation to reduce the risk of complications. Patients with a history of diabetes mellitus must have a glycosylated hemoglobin (HbA1c) of 7 or less to be able proceed with surgery. If the HbA1c is above this level, Dr. Couto will refer the patient to their primary care physician or endocrinologist to optimize your medications or diet to help lower the HbA1c levels. Lastly, nutrition is crucial for an effective healing and recovery process. Therefore, we recommend to our patients to optimize their protein intake and avoid foods high in salt/sodium after any surgical procedure. This could be easily achieved with post-operative supplements available in our practice.

We provide our patients with a detailed postoperative protocol to ensure that they have a comfortable and quick recovery. Rarely, patients experienced pain or discomfort following this surgery. It is very unusual for a patient to require narcotic pain medications.  We normally recommend our patients to take 5-7 days off from work (less if working from home). The same day after surgery, Dr. Couto always instructs the patient to have a couple of walking laps around the house or neighborhood. Patients can resume their aerobic exercises (eg. running, spinning, biking) 4 weeks after surgery and strengthening/abdominal exercises 6 weeks after surgery.

  • Smoothen transition between the lower eyelid and cheek region 
  • Optimize temple, cheek and jawline definition and contour 
  • Soften skin wrinkles and facial folds

Advantages: 

1) Fat harvested from your own body is being used to restore volume. Although filler injections are made of safe biological materials, these are synthetically produced. 

2) Fat is more cost-effective than facial fillers injections. Fat is readily available. 

3) Fat provides a permanent volume restoration. On the other hand, filler injections are temporary as they typically last 8-12 months.

4acbht52) Facial fat transfer is a quick and minimally invasive procedure.

Disadvantages: 

1) Unlike facial fillers, facial fat transfer is a minimally invasive procedure.

2) Recovery time can be greater when doing fat transfer, since patients can experience facial swelling and bruising.  

Schedule your appointment