Fat Transfer for Tear Troughs and Nasolabial Folds? (photo)

Hi Lance:

A couple of questions for you:  What do you weigh? Have you optimised your health and fitness?  Do you sleep well? Do you eat healthily?

Unfortunately, at your age you're just kidding yourself if you're thinking of using facial surgery or injecting techniques to improve your appearance without taking care of these things first. It just won't work.

I strongly recommend to take care of all the general health aspects of your body, weight and face, and take a year to work on it. I doubt you'll need anything done at all other than this.

Male faces are different than female, as well.  Often in men a little tear trough or NL fold may enhance the appearance, whereas in women it usually will not.

Do the work, get fit and lean, and reassess.  All the very best.

I think it's a great idea to try out a filler in this area before committing to fat transfer. Fat transfer to these nasojugal grooves is a more difficult procedure and can lead to lumpiness more readily than fillers like Restylane.

I think your plan is an excellent one.

Fat transfer to the tear troughs is certainly possible, but technique is extremely important. There should be extreme caution not to over do it in this region as the fat removal can be troublesome without an actual incision.

Start with a filler. At your age, you might see that you can go another 10 years or so without switching over to surgery.

Structural fat grafting is one of my favorite procedures and a surgery I perform multiple times every week. Having said that, I am also a proponent of filler for some cases.  I do not advocate any filler for the under eye area. Structural fat grafting is the way to go there. Look at many, many photos for evidence. When expertly administered fat grafting will leave this area with a smooth natural looking contour with results that can be permanent.  The results of fat grafting can create a youthful contour and a natural looking appearance. Filler can leave the area puffy, lumpy and uneven. Great results from fat grafting require expertise, meticulous surgical technique and specialized instrumentation. It is worth the time and and effort to find the right plastic surgeon to perform this procedure for you. 

It is always a good idea to do a trial of injectable fillers in these facial areas before fat grafting. See if you like the effect before proceeding with a more formal fat grafting procedure.

I encourage patients who have doubts about the results of tissue augmentation to do exactly what you propose. Remember that the Resylane will last at least 6-12 months. Select an experienced injector whose results you've seen. Unfortunately I  frequently hear that injections are easy; they are, but it is technically challenging to get a good result.