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.

Why should you trust your face to a Facial Plastic Surgeon?

In today’s world more and more people, both women and men, are seeking ways to maintain a youthful appearance. With so many different procedures available to enhance your cosmetic appearance, the cost of all these procedures can definitely add up. So what does the average person do? They look for affordable rates for procedures through places like GROUPON or they search for the cheapest alternative.

What are your risks by always looking for the cheapest alternative? Often times, quality care is what’s sacrificed in those bargains. This is not to say that there aren’t several reputable clinics and doctors who engage in offering the most competitive price, however, to offer such low prices, something is almost always sacrificed.

The purpose of this blog is to attempt to build value in the person you entrust your face to – the most prominent area on your body by which other people recognize you.

Let’s use dermal fillers for example, and we’ll assume that you’re interested in getting some Restylane. If you subscribe to GROUPON, you’ll see some offers like the one below offering a fifty percent discount. You’ll notice in this particular example, the offer sold out. 

We kept this offer anonymous because the purpose is to show how cost is the driving factor in people’s selection process of where they go to get their treatments. Perhaps the establishment offering this discount is reputable, that’s not the purpose of this blog, the purpose is to attempt to persuade you if you’re thinking of getting treatments – or any procedures done to your face – to entrust your face to Facial Plastic Surgeon.

To illustrate the value of going to facial plastic surgeon, let me draw the analogy of getting your hair cut. Your choices are to go to a place like Supercuts or to a salon where the stylists have some experience cutting and coloring hair. Obviously, the pricing will be different because the attention you receive is different.

The justification can only be trying to save some money. Ok, perhaps trying to save some money on your hair is understandable because it will grow back; however, trying to save some money on procedures involving the injection of a substance into your face is not something that should be considered solely on price.

Going to a proper facial plastic surgeon will probably cost you more money because we understand the value we offer since we are specialists when it comes to your face. We spend years in specialized training learning about facial beauty and facial anatomy as well as how to deliver the best results to each individual. The alternative is to go to a clinic that is allowed to perform procedures simply because they have the minimum requirement to do so. But more important, we spend time with you to make sure the results look natural and will give you that well-rested youthful appearance.

The flip-side can be devastating because obviously the results will show on your face. If you’re considering having a facial enhancement procedure, I suggest that you find a doctor that you’re comfortable with. Find one that will spend time getting to know you and what your cosmetic goals are. If price is an issue, often times, doctors offer financing terms and some are even willing to negotiate if you’re reasonable. 

As a Facial Plastic Surgeon who has performed many revision surgeries and has seen some devastating results to people who went to unreliable doctors, the best advice I can give you is to save money on other things. Set yourself a goal to save money to visit a specialist when it comes to your face.

If you’re interested in a no charge consultation with Dr.Sharma, please contact his offices at (305) 456-5727 to schedule your appointment. 

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.

Natural Looking Lip Enhancement with Dr. Sharma

If you’re considering enhancing your lips, then we encourage you to review Dr. Sharma’s Lip Enhancement Resource below.

Lip enhancement is a type of cosmetic surgery or non-surgical procedure that aims to improve the appearance of the lips by increasing their fullness through enlargement. Lips may be considered the most youthful aspect of a face, especially when complemented by high cheeks.

Now, you can enjoy plump lips with dermal fillers such as Restalyane, Perlane or Juvederm. The benefit to you is that you can immediately return to your normal activities. Restylane is a non-animal, clear gel that is reported to be very close to the hyaluronic acid found naturally in the body. The substance usually lasts four months in lips. While Juvederm is chemically similar to Restylane; many facial surgeons report that Juvederm is slightly smoother to inject. Dr. Sharma carries all three products in his Coral Gables clinic.

  

There are many options that now exist for improving the appearance of your lips, however, there is no doubt that successful lip augmentation is highly dependent on the skill of your facial plastic surgeon. Their skill should stem from many years of experience injecting the lips of many types of patients. Dr. Sharma has mastered the various injection techniques.

Dr. Sharma’s Procedure and Techniques


- Anesthesia: Local
- Location: Clinic
- Treatment time: 30 minutes
- Patient Status: Outpatient

Initial consultation

During your initial visit, Dr. Sharma will likely ask you to describe, in detail, what you would like to improve. We ask that you be specific about what you would like done. Bring photos that show what you like and don't like. Once Dr. Sharma fully understands your expectations, he’ll be able to consult with you to determine how your goals can be achieved.


Tell Dr. Sharma:

·   If you have any allergies

·   If you have a history of bad scarring

·   About any medications you are currently taking or recently stopped taking

You are at increased risk for complications if you have diabetes, poor circulation, heart, lung or liver disease, smoke, have a family history of blood clots, etc. You'll want to discuss your medical history thoroughly with Dr. Sharma.

Recovery

Pain Level: Mild discomfort.
Swelling or Bruising: Three (3) days to one (1) week
Exercise: Wait 2-3 days


To improve recovery:

·   keep ice packs applied to your lips for the first 24 to 48 hours

·   talking and chewing should be limited during the first 24 to 48 hours

·   limit smiling and laughing for the first few days

·   attempt to sleep in a semi-upright position during the first week

·   reduce the amount of bending over, straining, exercising or do any other activities that could increase pressure to your lips

·   avoid strenuous activities for 1-3 days

·   keep the lips clean to avoid infection


Risks and Complications

Major complications from lip augmentation are rare. With any surgical procedure, there is always a possibility of bleeding, infection, reaction to the anesthesia, slow healing or an unexpected result. Other possible complications include asymmetrical lips, cold sores, numbing, scarring, swelling, and permanent stiffness in the lip. Implant material can move to a new location within the lips and it may also protrude unnaturally. Allergic reactions such as itching, redness, and swelling may occur.


Here’s how Dr. Sharma does it:

Temporary Lip Injectables

Most lip plumping products are temporary. The ones that he uses the most commonly are Restylane, Perlane and Juvederm. Dermal fillers generally last around four (4) months in the lips, but can last a year or longer in other facial cosmetic areas. They are safe, generally don’t cause lumps or bumps, they’re very smooth to inject, and they look great.

Permanent Lip Injectables

Dr. Sharma regularly performs Permanent lip augmentation options. These include lip implants and other techniques. Please visit with Dr. Sharma personally to learn about these exciting and safe permanent options.

There are products that last longer than temporary lip injectables. Silicone, which lasts quite a long time, can be injected into the lips. However, permanent products that are injected tend to cause more problems in the long run because your body creates a little scar tissue around it, and it can create a little bump or a little lump. It can be visible and it can be painful. It should also be considered that once you insert something permanent into your lips, it can only be removed surgically.

We encourage you to contact our offices at (305) 456-5727 to obtain more information about your lip augmentation options.