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Is the Face Fat What Gives the Face Volume While the Bone and Muscle is What Sculpts the Face?

A few years ago, my surgeon performed some lipo on my face. I didn't like the way it turned out as it removed the entire third dimension of my mid-face area. I have a CT from pre and 1-2 years post procedure. 1. Would these CT's be helpful during consultation and also the procedure? What else should I bring? 2. Does the fat only give the face volume while the muscle and bone is what essentially makes you look like you? 3. Are there actual fat "pockets" you inject fat into in the face?

Doctor Answers (2)

Facial contour depends on all of the layers

+2

All of the layers, bone, muscle, fat and skin contribute to the shape of the face.  With aging, atropy occurs in all of these layers although the fatty layer is affected the most.  This is why overweight people tend to look younger in middle and old age than their thin counterparts. 

In your case, I think the scans would be helpful to your surgeon.  You may benefit from fat transfer or some other procedure(s) that adds volume.

When I was in training 20 + years ago, removal of some facial fat was a fairly common procedure to do in a young person.  Now it is rare as we now have a better understanding of how the face ages over time. 

I tell my "fat faced" young patients that they will really appreciate that extra fat is a decade or so. 


Seattle Plastic Surgeon
5.0 out of 5 stars 44 reviews

Facial Fat

+2

This is a really great question.  You are essentially correct when stating that the fat gives the face volume.  That said the bone structure can enhance or detract from this.  This is really evident in the cheeks and jawline. 

The fat is located in certain layers of the face.  For example the most superficial layer of significant fat is the SMAS.  This is the layer of tissue we manipulate during a facelift to correct cheek descent and jowling.  Restoring facial volume is best done with fat grafting.  I perform this using very small instruments and thus small products.  This fat is then placed withing the SMAS layer and superficial to it. Look for a surgeon who likes to perform this procedure.  Done correctly there is a very good "take rate" for the fat.  Done quickly and without care most of it will disappear.

Christopher L. Hess, MD
Fairfax Plastic Surgeon
5.0 out of 5 stars 17 reviews

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