I would like to correct the negative orbital vector and to build up my cheek volume. Would fat injections or an implant be better for this? I would prefer the fat injections; however, I am worried that the fat injections would not retain and may be lumpy since my tissue is thin in this area.
Answer: Mid-Face Rejuvenation With Injectable Volumizing Fillers Effective For Infraorbital Cheek Reflation From the photos, it appears that there is a significant absence of volume in the region of the mid face (i.e. below the under eye (infraorbital) region, which is contributing significantly to the elongation of the lower lids and the hollowing in that area. The use of injectable volumizing fillers can quickly and easily remedy the problem. In my Upper East Side Manhattan office, I would opt for Voluma XC for this purpose and in my Israel satellite facility, where a far greater number of regulatory agency approved volumizing fillers are available, I would opt for Stylage XXL or Restylane Volyme (formerly called Emervel Volume). In this facial location, results typically may last up to two years. The support provided to the under eye region by treatment would very likely, secondarily improve the hollowing to the extent that the infraorbital region might not even require any additional, direct treatment, or if it did, would require much less. I am not a fan of autologous fat injections, and gave up performing them many years ago, since the process tends to be expensive, requires TWO separate procedures (one to withdraw fat from the abdomen, buttocks and a second procedure for re-injecting the processed fat via a large bore cannula into the desired region). There is also the issue of lack of easy reversibility should there be lumps or other unwanted outcomes. And while the result of fat injections are oft touted as "permanent," a recent, January 2017 article in the highly respected trade journal, Journal of Drugs in Dermatology, the longevity of autologous fat injections was listed at only 6-24 months, a number that in my opinion hardly justifies the negatives mentioned above. You would do well to seek consultation and treatment by a board certified aesthetic physician with experience and expertise in treating the male face. This is not a region or situation that should be left to the hands of a novice injector accsutomed only to treating simple smile lines with ordinary Restylane or Juvederm. Inappropriate volume placed in the central portion of the face can feminize a male face. Make sure to ask to see his/her before and after photos before agreeing to proceed. Best of luck.
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Answer: Mid-Face Rejuvenation With Injectable Volumizing Fillers Effective For Infraorbital Cheek Reflation From the photos, it appears that there is a significant absence of volume in the region of the mid face (i.e. below the under eye (infraorbital) region, which is contributing significantly to the elongation of the lower lids and the hollowing in that area. The use of injectable volumizing fillers can quickly and easily remedy the problem. In my Upper East Side Manhattan office, I would opt for Voluma XC for this purpose and in my Israel satellite facility, where a far greater number of regulatory agency approved volumizing fillers are available, I would opt for Stylage XXL or Restylane Volyme (formerly called Emervel Volume). In this facial location, results typically may last up to two years. The support provided to the under eye region by treatment would very likely, secondarily improve the hollowing to the extent that the infraorbital region might not even require any additional, direct treatment, or if it did, would require much less. I am not a fan of autologous fat injections, and gave up performing them many years ago, since the process tends to be expensive, requires TWO separate procedures (one to withdraw fat from the abdomen, buttocks and a second procedure for re-injecting the processed fat via a large bore cannula into the desired region). There is also the issue of lack of easy reversibility should there be lumps or other unwanted outcomes. And while the result of fat injections are oft touted as "permanent," a recent, January 2017 article in the highly respected trade journal, Journal of Drugs in Dermatology, the longevity of autologous fat injections was listed at only 6-24 months, a number that in my opinion hardly justifies the negatives mentioned above. You would do well to seek consultation and treatment by a board certified aesthetic physician with experience and expertise in treating the male face. This is not a region or situation that should be left to the hands of a novice injector accsutomed only to treating simple smile lines with ordinary Restylane or Juvederm. Inappropriate volume placed in the central portion of the face can feminize a male face. Make sure to ask to see his/her before and after photos before agreeing to proceed. Best of luck.
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March 15, 2017
Answer: Improving Tear Troughs--Fillers (Belotero), Implants or fat You can have a successful result with fat to this area. A gentle technique is important for successful transfer and good results. I use gentle water-assisted harvesting to get the most viable fat to transfer. I then combine with prp to maintain and improve final results. Fillers are an alternative, which can be used for tear troughs and cheek volume, and allow you to try on the look before committing to a more permanent solution. See an expert for a formal evaluation. Best, Dr. Emer
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March 15, 2017
Answer: Improving Tear Troughs--Fillers (Belotero), Implants or fat You can have a successful result with fat to this area. A gentle technique is important for successful transfer and good results. I use gentle water-assisted harvesting to get the most viable fat to transfer. I then combine with prp to maintain and improve final results. Fillers are an alternative, which can be used for tear troughs and cheek volume, and allow you to try on the look before committing to a more permanent solution. See an expert for a formal evaluation. Best, Dr. Emer
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March 15, 2017
Answer: Negative orbital vector with under eye hollow Lower orbital rim or extended tear trough implant is a better solid foundation support to correct negative vector and hollowness. See an experienced oculoplastic surgeon.
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March 15, 2017
Answer: Negative orbital vector with under eye hollow Lower orbital rim or extended tear trough implant is a better solid foundation support to correct negative vector and hollowness. See an experienced oculoplastic surgeon.
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Answer: Fat injection versus cheek implant Cheek implants offer a predictable and consistent result when augmenting the mid-face. Fat injections are very unpredictable as to how much fat will live after the injections. Cheek implants are manufactured in a large variety of sizes and shapes, are usually placed through intraoral approach under brief general anesthesia as an outpatient procedure. For more information and many before-and-after examples, please see the link and the video below
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Answer: Fat injection versus cheek implant Cheek implants offer a predictable and consistent result when augmenting the mid-face. Fat injections are very unpredictable as to how much fat will live after the injections. Cheek implants are manufactured in a large variety of sizes and shapes, are usually placed through intraoral approach under brief general anesthesia as an outpatient procedure. For more information and many before-and-after examples, please see the link and the video below
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March 15, 2017
Answer: Cheek mcwa227, Although I perform fat injections I do them sparingly. I know some of my colleagues feel otherwise and that is good for discussion purposes but in the majority of my patients I can achieve improvement in hollowness under the eyes and cheek area using other more predictable methods. One of the drawbacks of fat injections is that one has to over-fill to begin with to account for expected absorption of some of the transplanted fat. That in and of itself is the reason I use this approach sparingly as the percentage that injected fat gets absorbed is different for each patient. I’ve seen patients with little absorption who look over injected for a prolonged period of time; I’ve seen patients who absorb the transplanted fat fairly aggressively (they look fairly good for about a year but after that you can barely tell you did any injections) and I’ve seen patients that get a good result that can last several years. I don’t like doing things that have that much variability. As the originator of the SOOF lift blepharoplasty I can tell you that in my opinion this is the best procedure for improving the hollow look under the eyes that accompanies the aging process. I've been doing nothing but this procedure since I originally published this approach around 1999 in the Archives of Facial Plastic Surgery and have only had one redo to date. For cheek’s I prefer a midface lift should they have adequate midface fat left and if not I prefer a cheek implant. All these techniques work predictably and last many years with little known risks. Always see a surgical specialist that does "onlyfaces" and has decades of experience. See the video and good luck!
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March 15, 2017
Answer: Cheek mcwa227, Although I perform fat injections I do them sparingly. I know some of my colleagues feel otherwise and that is good for discussion purposes but in the majority of my patients I can achieve improvement in hollowness under the eyes and cheek area using other more predictable methods. One of the drawbacks of fat injections is that one has to over-fill to begin with to account for expected absorption of some of the transplanted fat. That in and of itself is the reason I use this approach sparingly as the percentage that injected fat gets absorbed is different for each patient. I’ve seen patients with little absorption who look over injected for a prolonged period of time; I’ve seen patients who absorb the transplanted fat fairly aggressively (they look fairly good for about a year but after that you can barely tell you did any injections) and I’ve seen patients that get a good result that can last several years. I don’t like doing things that have that much variability. As the originator of the SOOF lift blepharoplasty I can tell you that in my opinion this is the best procedure for improving the hollow look under the eyes that accompanies the aging process. I've been doing nothing but this procedure since I originally published this approach around 1999 in the Archives of Facial Plastic Surgery and have only had one redo to date. For cheek’s I prefer a midface lift should they have adequate midface fat left and if not I prefer a cheek implant. All these techniques work predictably and last many years with little known risks. Always see a surgical specialist that does "onlyfaces" and has decades of experience. See the video and good luck!
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