- Dr. Jean-Paul Azzi
What is Fat Grafting?
Dr. Azzi, facial plastic and reconstructive surgeon at The Palm Beach Center for Facial Plastic & Laser Surgery, is often asked about the difference between fillers and fat grafting and the benefits of one over the other.
Besides texture and gravity, volume loss to the face has become increasingly recognized as an important component to the aging process, which can be restored with either dermal fillers or facial fat grafting.
The following metaphor can help us explain the role of fat grafting. When we are young, we are like ripe grapes. Our skin is smooth, tight and plump. As we age, we tend to deflate into raisins, losing volume and taking on a more gaunt or hollow appearance. Fat grafting can help “reinflate” the raisin in areas where there is volume loss.
So what exactly is fat grafting? Sometimes called “Fat Transfer,” it’s a gentle harvesting method, purification process, and micro-droplet injection technique. It involves removing fat from one’s own abdomen and injecting it into specific facial regions. The fat is injected as tiny little droplets into the areas of facial hollowness. Dr. Azzi uses a special technique he developed while practicing in Manhattan called multi-plane, micro-droplet fat grafting. This maximizes the percentage of fat transferred from the abdomen to the face that “takes” permanently. It also provides a smooth and natural result.
Dr. Azzi commented, “There are many advantages of fat grafting over using dermal fillers. The most practical is for someone who has a ‘gaunt’ appearance and needs a lot of volume. This can be financially impractical using dermal fillers if many syringes need to be opened. Another advantage is the fact that, if done properly, a significant percentage of the fat transferred can have a permanent take. It essentially becomes part of the face.”
Volume loss is generally more pronounced around the mouth, eyes, cheeks and jawline, and for that reason, fat grafting is most common in these areas. It is often combined with a comprehensive facial rejuvenation plan which may include a facelift, mid-facelift or blepharoplasty (eyelid lift).
Dr. Azzi always performs the “liposuction” and grafting procedure on the same day. “I have the fat processed immediately and gently to preserve the fat cells and stem cells. This allows me to transfer the fat and stem cells back to the face in micro-droplets, which has a higher rate of permanent take.”
We are often asked about fat grafting to smooth the appearance of acne scars. Dr. Azzi commented, “Acne scars are one of the most difficult things we deal with. These can be deep ‘ice pick’ scars extending to the muscular layer of the face. Facelift procedures can release the scar from the deep layer making the surface less of a ‘crater.’ Resurfacing procedures such as dermabrasion will also improve these scars to a certain degree. Fat grafting can help with the scarring by improving the overall appearance of the face. This includes not just volume but also skin texture since stem cells are simultaneously injected during this process. Improving the overall volume and texture typically leads to high patient satisfaction rates.”
Another common question Dr. Azzi gets about fat grafting is concerning the risks and complications. “The most common complications with fat grafting are the appearance of 'lumps' or other irregularities. This happens for several possible reasons. Most commonly, the fat cells are injected in areas that cannot handle such a large molecule. An example would be the tear trough under the eyes. The skin here is very thin and any large filler can appear irregular. I typically only use one or two fillers for such a delicate area. Another reason is technique. The fat should be deposited after treatment in micro-droplets. This should be done in multiple levels of the face but never too superficial to prevent the appearance of irregular lumps or bumps. Always trust your face to a specialist!”
Is fat grafting right for you? We invite you to come in for a complimentary consultation with Dr. Azzi at The Palm Beach Center for Facial Plastic & Laser Surgery. During your consultation, Dr. Azzi will take the time to understand your goals and explain which technique best suits your goals your individual appearance. He will also explain what can be realistically achieved with fat transfer/fat grating.
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