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Procedures

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We Look Older, Sad and Tired Because We Deflate, Not Because We Sag

Until recently cosmetic surgeons have believed that our faces look older because the skin and fat sag down. Today, we know that aging changes, and well as many unesthetic contours in young faces, are due to deflation of the face due to progressive loss of fat. Several years ago, Dr. McBride recognized this important concept and saw the value of filling the face with injectable fillers and the patient’s own fat. By doing more filling and less tightening, Dr. McBride found that his patients looked younger, more energetic, and happier.

Have you noticed that full-faced people look young and happy regardless of their age? Scientific studies show that our faces do not look older because of sagging, but because of deflation.  It is the loss of fat in our faces, not the sagging of skin, fat and muscle, that produces most of the changes that make us look older, tired, and sad. Jowls are due to loss of fat in front and behind the jowl area, not sagging of the jowl. In the past, surgeons would only lift the jowl with a facelift to improve the area.

Now, Dr. McBride treats the jowls by filling in front, and sometimes behind the jowl, with fat or long lasting injectable fillers, such as Radiesse, Restylane, and Perlane.  In patients with very loose neck skin, he may combine the filling with a conservative facelift if there is too much loose skin to correct with filling alone. The results are beautiful. There is less surgery, and a more natural, youthful improvement is obtained with less downtime.

Dr. McBride is excited to have the new scientific evidence to prove why filling with fat transfer, or injectable fillers, is so effective in restoring or creating a happy, rested youthful face. Even if you are young, and you feel that you look sad, tired, or old, you may find that a simple augmentation of the flat, depressed facial areas can make a dramatic improvement.

Because of the superb results and the simplicity of the recovery, Fat Transfer is the most exciting new technique in facial cosmetic surgery. The luminescent glow, round cheeks and soft-as-silk skin that babies are born with are universally appealing. But age and sun damage take a heavy toll on our skin. Over time, facial skin thins, creating sunken cheeks, unattractive lip lines, and depressions under the eyes. Fat transfer has dramatically improved our ability to restore ideal facial contours by treating the real problem, which is loss of fat, not the side effect which is looseness of the overlying skin.
Fat Transfer or Face Lift
For many men and women, rather than removing and tightening tissue with a face lift, it is better to replace the missing tissue with fat or fillers. Fat transfer will round out the facial contours by filling depressed areas, grooves and folds to create a more youthful, natural, athletic appearance with less surgery and less down time. Sunken cheeks, deep facial folds, depressions under the eyes, vertical lip lines, thin lips, and lines around the mouth can be filled and smoothed to restore attractive, youthful contours.
The Technique Is Important
Fat grafting techniques used in the past have had a bad reputation because they did not provided predictable results. This problem has been corrected by Dr. Sydney R. Coleman, who developed a technique which provides very predictable results. The keys to Dr. Coleman’s technique involve very gentle harvesting of individual fat cells, centrifuging the harvested fat to remove any damaged cells, and injecting the fat in multiple layers so that each cell is surrounded by blood vessels to provide oxygen and nutrients. By injecting very small groups of fat cells in multiple layers we can create very even, natural contours, and the fat will live for many years, if not a lifetime, exactly where we place it. Each fat cell is surrounded by tissue which holds it in place and prevents movement.
Fillers are an Alternative
If only a small area of the face needs to be filled, an excellent alternative to fat transfer is Fillers. They include Radiesse, Juvederm, and Restylane. These are made from materials that are identical to what is already naturally present in your body, and can be injected to fill depressions without surgery. (See the section on Fillers for more information)

Because fat transfer uses the patient's own fat cells to plump up facial features, the face maintains its soft, natural feel, and long lasting improvement has been noted in most patients.


Technique
Fat transfer is performed on an outpatient basis in our office surgical suite under light general anesthesia. Fat is harvested from the abdomen or thigh with a small needle. Only a few ounces of fat are needed. The fat is centrifuged to compact the cells for the most uniform augmentation, and injected into the face to fill grooves and lines, increase fullness, and restore youthful and attractive contours.
Because the fat is injected in tiny parcels through a fine needle, the edges of the added fat can be feathered to blend beautifully into the surrounding tissue contour. The surrounding blood supply keeps the fat alive and it becomes a living part of the facial tissues. The augmented areas look and feel perfectly natural because it is your own living tissue. The majority of the fat injected is maintained permanently in most patients.
Fat transfer is ideal for augmentation of all facial areas, and it is an excellent alternative to a facelift in patients with only moderate skin folds and laxity. It works well to help fill acne scars, and it can be combined with liposuction of the neck to develop an ideal jaw-neck line. Recovery is rapid, and most patients are able to resume normal activities within a few days. The tiny injection sites become invisible within a few days.