Fat Grafting: Rethinking Aging of the Face

A revolution is upon us today in how we see aging of the face and how we understand the aging process. In the past, the gravitational model held that all things fall including the brows, the eyelids, the cheeks, and the jawline. Using rigorous computer modeling and matching photographs of an individual over thirty to forty years in time difference what is revealed is that there is very little gravitational descent of the face, especially in the upper to middle third of the face. The jawline in individuals in their 50s and beyond can fall leading to a turkey gobbler deformity in the neck region but even this is partly due to fat loss in many cases.

What appears to be a hanging brow or upper eyelid must be re-envisioned as a balloon that is deflating. If one does not understand this, it is important to review one’s old photographs in one’s 20s and 30s to see that the brow in most cases does not fall but the eyelid and brow begin to collapse inward by loss of fat. Same with the lower eyelid region: what appears to be an eyebag that manifests really is nothing more than hollowness along the bony orbital rim. In some cases, an eyebag does protrude forward and needs to be removed, but in many cases it is just a question of fat loss that causes the problem. As far as the jawline is concerned, the front of the chin becomes empty with more bone exposure in front of the jowl making the jowl appear to be a jowl. In most early cases of jowl formation, it is not the jowl that is present but the bony dip in front of the jowl. It is a question of seeing negative space rather than positive space, i.e., seeing the loss of fat along the bony expanse rather than the existence of too much, i.e., too much eyelid skin, an eyebag, or a jowl. Training your eye to see what is not there will help you grasp the benefit of facial fat transfer.

This 48-year-old woman on the before image already had a facelift done elsewhere but clearly still looks very tired and aged. She is shown a year after just a fat transfer and is much more refreshed and youthful, all without any traditional eyelid surgery and without any incisions, cutting, or lifting.

Fat transfer as a procedure is relatively old, about a hundred years old, but not until the past 15 years has it been refined enough now that results are holding permanently and the results are looking natural and not overfilled. In addition early problems with lumpiness have truly been virtually eliminated in skilled hands. The process involves taking fat from the belly or thighs and moving the fat into the face through microinjections. When finding the right surgeon for you, it is important to find someone who is technically skilled and experienced but also matches your aesthetic desires. When you pick a painting, you pick the artist that appeals to you. That is also very important when finding the right aesthetic surgeon to help you with your rejuvenation.

Click to learn more about Dr Lam’s facial fat grafting procedures, including photos, videos, forums and FAQs or call 972.312.8188 to schedule a consultation .