Fat Grafting Following radio frequency
I have treated a number of patients who have experienced facial fat atrophy as a result of procedures which can heat the facial deep soft tissues excessively such as IPL or Thermage. Most of these patients come to my practice not only with areas of fat atrophy, but also with the frustration that their facial skin in the affected areas has lost its youthful quality. Remarkably, structural fat grafting has provided these patients not only with a correction of the soft tissue contour problem, but also with an improvement in the quality of the overlying skin.
Microfat grafting to face and periorbital regions
The reason that so few physicians perform the procedure is that it is technically demanding and prone to the risks that you have mentioned. Risks are generally lowered if conservative and multiple sessions are undertaken to achieve a gentle and gradual augmentation. The area around the eyes is especially prone to visibility and attention to detai and technique are essential.
Fat grafting can be rewarding
fat grafting varies in the percentage of fat which permanently survives. in general, fat grafting can have significant effects at adding volume to areas such as temporal wasting, infraorbital hollowing, loss of cheek mass, just to name a few examples. i find it critical to have enough stable donor fat. i find very thin, ectomorphic patients with high metabolism difficult cases.
most patients recieve great reward, including improvement of skin tone overlying the fat transfer.
fat injections are capricious in their results. It is not a predictable procedure. Some patients derive very good benefits and with long term improvement, but others don't seem to be able to obtain more than several months of volume augmentation. The fat may at times appear lumpy. The area around the eyes can show more of this uneveness or even bumps as the skin is very thin. That's why more physicians deal with thin off-the-shelf fillers for this purpose, but some of my satisfied patients have been those that have many years success with fat injections.
Fat Transfer Following IPL/RF
Thanks for the question. I have had successful outcomes following laser/IPL/RF treatments using fat transfer (see the video testimonial shot at 11 months. photographs on my site are at 15 minutes following a single session of fat transfer for a patient after supposed IPL injury). Although none of us is clear as to whether fat transfer is effective in every case, but I am confident that it will work well.
Fat grafting works tremendously well to counteract facial volume loss of most kinds and stay safe without lumps or cysts in almost every patient if you are a skilled fat transfer surgeon. I would say the risks that I am more worried about are the following:
1. realistic expectations of what i am trying to achieve. sometimes we look at every nook and cranny needing filling. i don't believe that is possible with fat. fat provides an overall beautiful result (see my photos on my site. link below to fat transfer home page) for the face.
2. if the person is very young say below 30 or so and has not had children, the one thing that i am worried about is future weight gain with metabolic slow down etc. now the good thing is that if i am just treating some early aging, i am conservative with the fat application to begin with so that tends to work well even for future aging.
3. since fat is a live graft, i place the fat relatively symmetrically because it might grow differently if you treat one side with a ton of fat and the other with less. accordingly, i do not use fat to try to correct micro asymmetries or even major asymmetries because of long-term safety.
these are some of my initial thoughts. please look at my website to get a much more detailed understanding. i also have a forum on their dedicated to fat transfer in which i could respond to similar questions.
dr. samuel lam
facial plastic surgeon