How to restore youthful fat back into the face? (Photo)

Question

As a person gets older how would they be able to maintain the youthful and bubbly appearance of the early 20s into their early 40s? Living a healthy lifestyle, good medical grade skincare are of course all a prerequisite and enhances results, but how exactly do you mimic the youthful fat you had in this time. Are there any fillers that mimic fat or is fat transfer a better option. How do you also avoid looking blocky or overfilled. Some celebs seem to have more volume than when they were younger

James M. Economides, MD, FACS · Answer

Maintaining a youthful and vibrant appearance as you age involves a combination of strategic aesthetic treatments and a natural, balanced approach to avoid the "overfilled" look. Here's a breakdown of how to achieve this:

1. Mimicking Youthful Facial Fat:
Fat Transfer: Fat transfer (or fat grafting) uses your own fat harvested from areas like the abdomen or thighs, which is then injected into areas of the face where volume loss occurs. This technique mimics the natural fat that diminishes with age. It offers a more permanent solution than fillers and provides a soft, natural result because you're using your own fat cells.
Fillers That Mimic Fat: Hyaluronic acid (HA) fillers like Juvederm Voluma and Restylane Lyft can provide structure and volume similar to youthful fat. These fillers are excellent for contouring the cheeks, temples, and jawline, but they aren’t permanent. They last around 6-18 months depending on the product and placement.
Sculptra: This is a poly-L-lactic acid filler that stimulates collagen production. While it doesn't add volume immediately, over time it can help rebuild your skin’s natural collagen stores, giving a fuller and more youthful appearance. It's often used for facial volume restoration without giving a "puffy" or overfilled look.
2. Maintaining a Natural, Non-Overfilled Look:
Layered Approach: Many celebrities who maintain youthful appearances use a combination of fat transfer and fillers to restore volume while avoiding an overly full or "blocky" look. The key is subtlety. A skilled injector will layer smaller amounts of filler over time to gradually maintain youthful contours without overfilling any one area.
Facial Proportions: One of the keys to avoiding the overfilled look is maintaining proper facial proportions. As we age, some areas lose volume (like the midface) while others may appear fuller due to sagging or fat redistribution (like the lower face or jowls). Careful attention to these proportions during treatment ensures that volume is restored in the right areas, without creating an unnatural shape.
Strategic Areas for Volume: Focus on areas that naturally lose fat with age, like the temples, cheeks, and tear troughs. These areas can be filled subtly to lift the face and create a youthful contour, while avoiding over-inflating areas that can give a blocky or puffy look.
3. Celebrity Techniques:
Combination Treatments: Many celebrities use a combination of fillers, fat transfer, and collagen-stimulating treatments like Sculptra or Profhilo to maintain a natural but youthful look. This combination helps maintain volume while keeping the skin looking fresh and firm.
Non-Surgical Skin Tightening: To avoid sagging while maintaining volume, treatments like radiofrequency microneedling, ultrasound (Ultherapy), or lasers can help tighten the skin, lifting the face naturally without needing to add excessive volume.
Preventive Care: Celebrities often start with small, preventive treatments in their late 20s or early 30s to maintain youthful contours over time, rather than trying to restore everything all at once later in life.
4. Tips to Avoid Overfilling:
Conservative Approach: Always aim for less filler and reassess after the product has settled. This helps avoid the puffy, overfilled look.
Experienced Provider: Choose a highly experienced injector who understands facial anatomy and aging patterns, and who prioritizes natural, proportionate results.
Combination of Treatments: Use small amounts of filler in combination with skin-tightening treatments to lift and firm without needing large volumes of filler.

Anna Chacon, MD, FAAD · Answer

Restoring youthful fat back into the face can be achieved through several procedures and treatments. Here are some options:
1. Dermal Fillers: These are injectable substances used to add volume to areas of the face that have lost fat. Hyaluronic acid fillers are the most commonly used. They can add volume to the cheeks, lips, and around the mouth.
2. Fat Transfer: This is a surgical procedure where fat is harvested from another part of the body, processed, and then injected into the face. This can provide a more natural look and is a more permanent solution than dermal fillers.
3. Sculptra Aesthetic: This is a type of filler that stimulates your body's own collagen production to restore facial volume.
4. Facial Exercises: Some believe that facial exercises can restore volume by strengthening the facial muscles, though the effectiveness of this method is debated.
5. Healthy Lifestyle: Maintaining a healthy diet, staying hydrated, and getting regular exercise can help maintain overall skin health and may contribute to facial volume.
6. Topical Creams: Some creams and serums claim to restore volume and plumpness to the skin, though results can vary.
Before deciding on any procedure, it's important to consult with a qualified healthcare provider or a cosmetic surgeon to discuss your goals and options. They can provide recommendations based on your specific needs and circumstances.

Nelson Lee Novick, MD · Answer

Age-related fat loss is indeed responsible for many of the unwanted changes that occur with time.  And so the restoration of this lost volume (along with proper skin care that preserves and maintains "fabric" envelope of our skin) are integral and complementary parts of treatments and regimens to preserve and restore a more youthful face. While theoretically promising to last longer, fat injections (which I gave up performing decades ago) have limitations. For one thing, they are expensive. For another, they require TWO minimally invasive procedures--one to extract the fat with large cannulas from donor sites, like the thighs, belly or buttocks and another to inject them with large cannulas into the face. In addition, much of the fat transplanted does not take in the recipient area once separated from its original blood supply. On the other hand, nowadays we have relatively long-lasting, durable, robust HA fillers that can revolumize sinking cheeks and improve nasolabial folds and others that lift and straighten the angles of the mouth and treat marionette lines, and still others that straighten and define jowly jawlines. And, in the hands of an experienced, board certified, cosmetic dermatologist can be accomplished in one treatment session of about 30-45 minutes without ending up having "chipmunk" or artificial "apple" cheeks or "duck" lips. . Hope this helps and best of luck..

Camille Cash, MD · Answer

I encourage you to explore Renuva.  This filler is different than traditional HA fillers.  It provides volume when injected, however over time as the product is metabolized it is replaced by your body's own fat.  This gives a longer lasting result.  Visit my website or a provider near you to learn more.

Sarah Kennedy, MD · Answer

Great question! There are two main ways to help restore volume to the aging face - nonsurgical injections and surgical injections. For nonsurgical options we use hyaluronic (HA) fillers (like Restylane and Juvéderm) or Sculptra (poly-L-lactic acid). Both of these "fillers" are synthetic and can address volume deficiency either immediately (HA fillers) or overtime (Sculptra) and are often popular because they do not require an operation. For surgical injections, surgeons will harvest fat from your own body via liposuction and then inject the fat into fat compartments in your face - this is called Fat Grafting. The downside is that it requires an operation, but the plus side is that it will be a more permanent solution to volume loss. The best way to not look overfilled is to be injected by an experienced injector and surgeon, and to be gradually filled overtime, instead of all at once, to make sure you are happy with your results.

Leonard Grossman, MD · Answer

There is absolutely nothing out there that is better than the patients own fat when it comes to facial rejuvenation. As long as the individual (Plastic surgeon) has a lot of years of performing facial rejuvenation with fat grafting, the results should be extremely natural and practically permanent. In order to have permanent results, the Plastic surgeon has to use fat that is appropriate for such procedures as not all fat is the same. I hope this helps and good luck from New York City Plastic Surgery.

Jared Blau, MD - Account Suspended · Answer

Most fillers we use today are made of hyaluronan, which do a nice job of mimicking fat. They are hydrophilic and draw in water molecules to increase the soft volume of the areas, which is why they tend to work so well. Fat transfer, if you ever decide to do it, takes less than an hour and the results are very long lasting

How to restore youthful fat back into the face? (Photo)

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