What Is The Best Way To Improve Injectable Fat Grafting To The Face?
Q: Dr. Eppley,I had cheek, infraorbital rim and paranasal implants placed last year. While they have helped the look of my flat midface significantly, the implants look a bit ‘skeletonized’ and need some additional volume around them to create an overall fuller facial look. I know that injectable fat grafting is the only long-term option available but I am concerned that I will spend a lot of money and it will not work. What are some insights to improving the success of fat grafting to the face?
A The take of injected fat is a multifactorial issue and includes where and how it is harvested, the technique of concentration, the method of injection and what facial area is being injected. (cheek and the midface have the highest average percent of take) Because of all of these variables, most of which are not understood how they influence the process, it is no surprise that fat grafting remains as much an art as a science. It is also fair to say that all surgeons who inject fat are not created equal.
The most important key in properly injecting your facial areas of concerns is to have enough fat volume to do it. The surgeon must harvest at least 60cc and concentrate it down to 15cc to 20cc. (it takes far more fat than one would think to really create the overall volumetric increase that it is needed) I personally prefer to add to facial fat injections a PRP solution to have a ‘booster’ effect. PRP (platelet-rich plasma) is an extract of your own blood that adds numerous growth factors and cytokines which theoretically improves fat cell survival and stem cell conversion.
Dr. Barry Eppley