We have said it many times—volume is youthful. Even thin, young people have volume in their face. Heavier people tend to look younger for longer. As we age, many of us lose facial volume. It can be replaced using injectable fillers like Juvéderm, or through the use of fat grafting, with very good results. Most facelift procedures benefit from the softness imparted by volume. By itself, or in combination with other procedures, the addition of volume is a significant part of cosmetic facial rejuvenation.
We’ve performed fat grafting for decades. The most recent advancements have been in the harvesting, cleaning and preparing of the fat cells. We now have systems in place that wash and prepare the fat cells, providing us with very clean and viable material for injection. This increases the predictability and survival rates of the cells, which elevates our confidence in a good result.
Using a special syringe, fat cells can be harvested from the belly, thighs or other natural areas of accumulation. These extractions are put into a system where they are washed, sorted and prepared for injection. The cells will require good blood flow in order to survive, so they are injected into many different levels throughout the area we are trying to enhance. We slowly inject about a tenth of a cc into one track and then move on to another track. In an area like the cheeks, we will typically put 20–30 passes in this area. Other areas that can benefit are the lips, chin, the forehead and around the mouth.
Off-the-shelf fillers are consistent and convenient. They come right off the shelf ready for injection. Injectable fillers last about a year, whereas fat grafting, since it’s using living cells, can last three times longer, or more. Naturally harvested fat cells also include a certain amount of stem cells which are believed to have rejuvenating properties.
Another big advantage fat grafting has over other fillers is the large amount of material you can have available to inject. Off-the-shelf fillers are expensive, so the volumes we inject are typically lower. For example, we’ll use about 2 cc’s of Juvéderm Voluma per cheek, which costs a little around $1,800. With fat grafting, we have plenty of extra material to work with and we’ll be able to inject 5 to 10 cc’s per cheek. Fat grafting may initially appear more expensive because it’s two procedures instead of one: a harvesting procedure and injection procedure. But as we harvest additional material, and considering that that material can last three times longer or more, it becomes a cost effective option.