What is Facial Enhancement using Fat Transfer?

Fat Transfer or fat grafting usually involves harvesting fat from one part of the body, purifying it and then carefully re-injecting it into the area needing attention. Fat injected into areas that require volume enhancement produce safe, long-lasting, and natural appearing results. There is no other field of medicine which demonstrates the degree of innovation that is seen in plastic surgery. The concepts and techniques used are dynamic and constantly seek to improve efficiency, comfort and safety in the interest of the patient.

One of the most significant trends today is the replacement and enhancement of facial volume. It has been shown that a reduction in fullness of the cheek area gives people that “aging” look. This hollow look usually worsens with age but can be present in younger people if they are genetically predisposed.

Hollow cheeks make people look:

1. Older

2. Sad

3. Tired

Restoring this lost volume will make a significant difference by creating a younger, fresh look. The overstretched look which can result from the common facelift may have fewer wrinkles, but does that person really look younger?

Who is a candidate?

Patients that are generally considered a good candidate for fat injection are in good health. If you have any history of abnormal bleeding, or swelling following a procedure then you should mention this during your consultation. If you’re a smoker, then this is something you should definitely disclose as well.

Patients interested in fat transfer do require a thorough consultation. A full history and physical exam will be required before your procedure. Pictures are taken before the procedure and an informed consent form must be obtained. Either local or general anesthesia may be used as every case is specific to the patients’ needs.

Some common side effects of fat transfer:

1. Swelling is the most common side effect and should settle down within several weeks

2. Bruising

3. Numbness

4. Slight asymmetry which should improve as swelling improves

5. Infection

6. Loss of volume

An alternative approach involves a procedure called fat transfer. In this technique, I take excess body fat from the abdomen or inner thigh using liposuction instruments. The fat is then prepared and concentrated under sterile conditions and carefully injected back into the areas of volume deficiency. The result is a permanent enhancement of that area without the risk of allergic reactions or possible complications with implant materials. Not only has fat transfer proven to be an excellent technique for enhancing the cheek area, but it’s also successful in improving jaw line definition (delaying the need for a facelift), improving the appearance of the upper and lower eyelids, and even enhancing temporal deficiencies (the sides of the forehead).

There is some evidence that fat transfer may help with overall skin quality, possibly due to the stem cells within the transferred fat. The discussion of the benefits of stem cells in controversial and I suggest you discuss these issues with your provider – preferably a Double Board Certified Facial Plastic Surgeon like me.

In the image above, I injected fat from the patient’s abdomen to her cheek areas. This patient also had excess skin removed from above and below her eyes (upper and lower blepharoplasty). Notice that two weeks after her surgery, her cheeks are visibly enhanced. Some swelling remains, however, it should subside within another week or two and she will begin to see the final results of her cheek enhancement.

It is a safe, conservative technique which if properly planned and performed gives a long-lasting result indistinguishable from your natural facial contours. To watch me perform fat transfer, please click this link to my YouTube Channel.

To contact my offices please call (305) 456-5727 and I’d be happy to answer any questions you might have about facial volume enhancement.

Secondary Facelifts Explained by a Facial Plastic Surgeon

If you underwent a facelift several years ago and were satisfied with the results but are now starting to notice some degradation, you are a likely candidate for a secondary facelift to restore your youthful appearance.

Secondary facelifts are sometimes referred to as ‘facelift revision surgery’ or ‘reverse facelifts’. They are performed either to restore the results achieved with the original facelift surgery, or to correct a faulty procedure. Even the best facelift can only provide temporary benefits because of the gradual reappearance of the signs of aging. A secondary facelift is a common procedure, performed to regain that natural well-rested youthful appearance.

Here is a link to Dr. Sharma's Official YouTube Channel. In the video below, Dr. Sharma discusses facelifts from his Coral Gables offices. 

Many people choose to do a secondary facelift because the results of their original facelift have faded. A facelift (rhytidectomy) have results that usually last on average for about ten years. Secondary facelifts usually become necessary around this time. Some people might even choose to have a less invasive means of rejuvenating the appearance of their face by the use of dermal fillers.  Dermal fillers can help with reducing the appearance of lines and wrinkles and also reduce the appearance of nasolabial folds (laugh lines). Rhytidectomy eventually becomes the best option for a more permanent treatment.

Second Facelift Procedure

The actual procedure of having a secondary face lift may involve the same area as the first or may even be expanded to improve the appearance of other areas of the face. More than likely there will be some amount of scar tissue in the face from the previous surgery. The scar tissue, if not too extensive, can actually help limit some of the bleeding and scarring. Dr. Sharma will discuss with you your options for treatment and review with you exactly what kind of facelift will be necessary to get the best results.

Risks of a Secondary Facelift

The risks of face lifts include:

• Bleeding

• Bruising

• Infection

• Nerve damage

• Facial asymmetry

• Anesthetic risks

In general, most people enjoy the aesthetic results for 10-15 years before they seek a secondary facelift. Facelifts are one of the most common plastic surgery procedures chosen to be redone because the face continues to highlight the signs of aging more visibly than any other body area and it features our most distinguishing and identifiable physical characteristics.

Most patients are extremely happy with their primary facelift and therefore, when the rejuvenating effect begins to fade they decide to have a secondary facelift to achieve that same level of rejuvenation they originally enjoyed. If you were pleased with the results from your first facelift, there are other considerations that will help you efficiently embark upon your revision facelift process with Dr. Sharma:

• Remind yourself about the specifics of your original facelift surgery. You will want to share the details about this previous procedure that yielded such favorable results for you.

• Know exactly what you're trying to improve with this facelift, and communicate this to Dr. Sharma. Even if you were pleased with your original facelift, you may have different wants or expectations now.

• During the consultation, bring in before and after photos of yourself from the first surgery that way Dr. Sharma can refer to these images while considering your current options to create a more personalized surgical plan for your second facelift.

If you're looking into revision facelift surgery to correct poor results from your first facelift, Dr. Sharma suggests that it is prudent to take certain steps the second time around. He has many years of facelift experience behind him and is able to make personalized suggestions and recommendations for your surgery, however, you should consider these questions and in preparation for your consultation with him:

• Identify what specifically displeased you about your original facelift results, and clearly communicate this during your consultation. 

• Be very specific idea of what you want and share all your thoughts with Dr. Sharma.

If you are interested in speaking with Dr. Sharma about a secondary facelift or facelift revision surgery, please contact his offices at (305) 456-5727 to schedule an appointment for a consultation.

About Dr. Vijay Sharma

Vijay M. Sharma MD, MPH is a Double Board Certified Facial Plastic Surgeon and a co-founding member of The Plastic Surgery Institute of Miami. He exclusively focuses on cosmetic procedures and surgery of the face. This specialization includes the face, neck, nose, eyes and ears. Born and raised in Maryland, Dr. Sharma attended college and medical school at The George Washington University in Washington, DC. He went on to a successful head and neck surgery residency at Tulane University in New Orleans. Dr. Sharma distinguished himself as the Chief Resident of Head and Neck Surgery at the world famous Charity Hospital of New Orleans. He then completed the prestigious Glasgold Fellowship in Facial Plastic and Reconstructive Surgery. Dr. Sharma moved his New York area private practice to Miami and Coral Gables in 2007.

Facelifts and Necklifts in Coral Gables by Dr Vijay Sharma

Are you in your 40's or beyond? Are you concerned about the looseness of your neck and/or loss of jawline definition due to jowling? Do you have concerns about the smile lines between your nose and mouth? Are you dissatisfied by the way you look in the mirror, from the side, or in photos? Have you ever considered a cosmetic procedure to look and feel better but want to stay looking natural? If you answered yes to these questions, then let Dr. Sharma help.

These common concerns may be addressed with a facelift. Dr. Sharma is comfortable with multiple types of facelift procedures and tailors each patient's procedure to their specific needs, concerns, anatomy, and physiology. "In performing over 2,000 facelifts, I have come to appreciate the artistry involved in making people look younger and better with a natural appearance. We have all seen patients that look over-stretched or pulled. My overwhelming experience is that patients prefer to look well-rested and natural. Not wind-swept and not weird! In my office, I'm pleased to say, we consistently achieve outstanding natural appearing results."

In the video below, Dr. Sharma discusses the basics about facelift procedures.

A facelift is also known as a 'rhytidectomy.' The overall principal behind this procedure is to tighten the tissues underlying the skin to improve the appearance of the neck, jawline, and in some cases, the smiles lines between the nose and mouth. There is also careful removal of redundant (extra) skin. There are a variety of facelift procedures available to patients today.

Less invasive procedures may generally be performed in the office under local anesthesia. Bigger, more extensive procedures tend to be performed under IV sedation or general anesthesia in an operating room. Any patient considering a facelift should discuss all the options available to them with their surgeon.

Here are a few Before and After pictures of some of Dr. Sharma's patients who underwent a faceleft and necklift procedure.

If you're interested in learning more about having a facelift and/or necklift procedure with Dr. Sharma, please contact our offices in Coral Gables at (305) 456-5727.