My Newfound Love of Fat – and its Use in Facelift Procedures
By: Braden C. Stridde, M.D.
Dr. Braden C. Stridde, who performs facelift surgery using fat transfer at his Seattle-area practice, explains the development of this innovative technique and how it improves upon past facial rejuvenation methods.
It may sound counterintuitive coming from a plastic surgeon, but I have a newfound love of fat. That's right – fat is enjoying a new appreciation for the benefits it provides in facial rejuvenation procedures, particularly in combination with facelifts. I'm so enamored that I've started using fat transfer for my Seattle-area facelift patients. Let's take a look back to better understand how this technique developed and how it can benefit patients.
Our older concepts of facial aging were focused primarily on the increased laxity of facial skin and the descent of facial tissues that occurred over time with aging. The operations to reverse these changes primarily focused on lifting and tightening facial tissues to restore a more youthful appearance.
Depending on the procedures used and the characteristics of a patient's skin and soft tissues, the results could be pleasing or at times appear unnatural or overdone. This led surgeons to re-evaluate their techniques to try to better understand the facial aging process. The advent of digital photography and standardization of photographic techniques helped us understand that facial tissues didn't only descend, but that there was loss of tissue volume in many areas, as well.
So a more complete approach to rejuvenation would include restoration of the lost volume. It turns out that fat transfer can be used in conjunction with a facelift to correct many of the volume loss changes that occur with facial aging.
Now sometimes referred to as "liquid gold," a patient's fat can be removed via liposuction from an area of relative excess, such as the abdomen or hips, and then processed and transferred into areas in the face where volume loss contributes to an aged appearance. This process is called autologous fat transfer, or AFT.
Plastic surgeons have been doing fat transfers for many years, but only in the past decade have the techniques been refined to allow it to be used with consistent results. As we have gotten better at fat grafting, surgeons are finding more and more uses for patients' own fat. In facelift procedures, the fat is used to restore a soft and natural fullness to areas where volume loss can occur. These can include the nasolabial folds, chin and marionette lines, the lips, the upper cheeks, and around the eyes.
Like any treatment technique, fat grafting can be overdone and, if not performed properly, can result in an unnatural appearance. This is why it is critical that surgeons performing the procedure have extensive experience in the techniques of autologous fat transfer, as well as excellent aesthetic judgment about how it is applied to each person's unique anatomy. At my practice near Seattle, autologous fat transfer has truly helped us to improve the outcomes of facial rejuvenation surgery.