Introduction Maintaining a rejuvenated face is todays social requirement and more so for personal psychological relief. The nagging though of not being good looking or the thought of being old is disabling, and particularly when today we can modify a person’s looks by the skillful use of Plastic Surgery. Some of the procedures we use are fat injection, restylane injections and botox
Facial Lipostructure Dr Goldmann is famous for his work on fat injections and using fat for facial rejuvenation. The area of the face which is most responsive to fat injection are the nasolabial lines. Use of restylane and other fillers is common in the nasolabial lines, the naso-jugal groove, and other areas showing depression. But the problem with fillers is that they are expensive and are temporary. The latter aspect is also thought to be a beneficial aspect, since any irregularity is at most going to last for 5-6 months. However here fat scores very highly, in that the procedure is a one time affair, uses self fat (autologous fat transfer) and tends to be permanent. It is specially suitable for the nasolabial lines, which are notorious for their irresponsiveness to treatments. Special instruments are available for releasing the nasolabial lines and then injecting fat there to correct the depression.
The trick in autologous fat transfer is the processing of fat. It is important to not to expose the fat to air, since it degenerates very fast. Also we must be careful to isolate the fat cells, and not the oil. Further there is a distinct stem cell layer in the form of a clot. It is mandatory to preserve this. Failure to follow these precautions is responsible for the oft repeated poor results seen with fat injections. Fat has to be treated gently like babies.
Lip Augmentation Many men and women are born with thin lips, and there is a constant desire to achieve more fullness in this region. Thus a number of clients request for filler injections in the lip and along the lip margin. Again we need to remember, that fat is an excellent filler for lip augmentation. Fillers are better to highlight the lip margins, because the size of fat cells tends to leave a clumpy appearance at the lip margins.
Possible problems with autologous fat Injection of fat necessitates a small liposuction in the region of the abdomen and/ or thighs to harvest fat. Though this can be done under local anesthesia, the patient must know that an additional procedure is required, since fillers come prefilled into syringes. The harvested fat is then carefully processed and transferred to smaller syringes. This is then injected into the desired area. There is a swelling in the injected region. In the region of the lip, this can last for between 3-6 weeks, so social appearance in this time will need to be curtailed.
30-50% of the injected fat may be resorbed, and thus whenever we inject fat, we always inject about 30% extra. This is responsible for the over filled look initially but always settles down within 6 weeks.
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