What is LiveFill (R) and Why is It Better Than Your Own Fat or Restalyne for Tear Troughs?

Hi there-

Unfortunately, there are doctors and clinics in the world who believe it is ethical and moral to mislead people into thinking they have somehow captured magic in a bottle or that they are the only ones capable of a certain procedure or benefit- by giving their procedure a cute name. Some even copyright these names- so that they can say "you can only get it from me"...

When the reality is that whatever they are doing has been being done by other surgeons for years.

Personally, I think Restylane is the current gold standard for improvement of the tear trough deformity. It's effective, easy, inexpensive, last a relatively long time, and does not require surgery or a recovery period.

Finally, I would add that my opinion is that good medical care (whether we're talking about heart surgery or cosmetic treatments) requires finding responsible, ethical, professionals- people you believe you can trust to make good decisions and "do the right thing".... Personally, I would have a very hard time bringing myself to trust someone I knew was resorting to these kinds of tactics to try to attract patients.

If you can't invent something new, coming up with a catchy name is almost as good.  Livefill is just a trade name for a fat and dermis graft.  The developer of the method claims the fat is removed intact and is less more likely to survive.  There are no adequate scientific studies that really answer this question.  Is Livefill better than Restylane?  Well livefill requires a surgery.  This means definite healing and recovery issues both for the area at the bottom of the tummy where the fat and dermis is harvested and also where it is placed in the face.  Any living graft is associated with the risk of bruising, infection, irregularities.  Irregularities that persist may require additional surgery to address.  If you gain weight, your grafts may gain weight.  Longevity of the grafts?  What takes survives.  However, due to the swelling associated with the surgery it is likely that you may feel that not all of the volume has persisted once the swelling settles down.  You might feel you need more volume to address this.  Compare these uncertainties with Restylane.  The service is provided without surgery as a very comfortable office treatment.  The treatment lasts over a year, possibly longer.  Downtime is about a day or so, although it is possible to bruise from treatment.  If the treatment needs to be adjusted for any reason, an injectable enzyme can be used to modify the treatment.  These fillers are very popular because the results are at least as good and in many cases far better than what can be accomplished with surgery.  Ultimately you have to decide for yourself what is best.  Just be aware that many of these services whether we are talking about fat and dermal grafting or filling with Restylane requires an artist eye to get the best results.  These are not commodity type services where the treatment results are the same irrespective of the surgeon doing the service.

Solid fat/fascia and fat dermis grafts are another means by which facial soft tissue volume may be significantly and permanently enhanced.  As with fat grafting, survival of the grafted tissue is variable and some of the graft material is reabsorbed.  As with fat grafting, potential complications such as infection and cyst formation are possible.  And as with fat grafting, appropriate preoperative planning and surgical technique are required in order to obtain ideal and lasting results.  In my opinion structural fat grafting is more versatile, as fat can be easily and rapidly added to any tissue plane (level); and it has the added benefit of the ‘stem cell effect’ which is difficult to quantify but unquestionably present in many cases.

Both structural fat grafting and fascia-fat (or dermis-fat) grafting can be competently performed (or not) by Board-certified plastic surgeons.  Neither should be trademarked or considered proprietary.Look at many, many before and after images for evidence of efficacy with any procedure including fat grafting.

 LiveFill(R) is reported as a fat-fascial graft that's taken from the pubic area and placed into areas of hollowness of the face.  I wouldn't use or recommend this tissue/fat combo graft for the face as it would, IMO, have the same limitations as a fat transfer or fascia graft transfer which are not new and have been around for decades.  Both fat and fascia do dissolve with time, IMHO and I see no reason that this wouldn't do the same.  

 The problem with this type of combo graft taken from the pubic area, IMO, is that hair follicles are sometiomes included in the graft and I have seen patients with pubic hairs literally growing out of thier lips from a similar graft placed elsewhere (I don't recall the Surgeon who placed the graft).  Needless to say, this very attractive young woman, in her twenties was not happy that she had to pluck hairs from her lips.

Using fillers and cheek implants for facial augmentation, is more reliable than fat, fascia or a combination thereof IMHO and why take risks when there's a proven more reliable method of accomplishing the same goal? 

The LiveFill , a graft of fat and fascia which was described many years ago, is one method of augmenting the undesirable tear troughs. There is no scientific scientific evidence that it is better than other alternatives such as your own fat or fillers. Potential risks include problems with survival and the possibility of an irregular contour after placement. Success with all these procedures will depend on the experience of your physician.