Fat Transfer is one of the most popular and common procedures we perform at Carmel Valley Facial Plastic Surgery.
It is essentially the cornerstone of our facial rejuvenation program. The main reason for this is that it is extremely effective
and the results are permanent. We perform this procedure alone or in conjunction with other facial rejuvenation procedures such
as facelifts and eyelid surgery (blepharoplasty). The key to success is highly based on the surgeon's experience and technical
abilities. Dr. Karam is among the most experienced fat transfer surgeons in the country.
The Problem: As we age, the layer of fat under our facial
skin begins to thin. This causes the face to look deflated and drawn when compared to the
full roundness of a younger face. Especially around the eyes, hollows and contour changes
leave the face looking older and more tired. Volume loss is one of the earliest signs of
aging. It starts to occur in the mid 30's and continues to progress. Until recently, this
component of facial aging was overlooked. We are now realizing what a major contribution
volume makes to looking younger, healthier and more energetic.
Dr. Karam's wife! 3 years following full face fat transfer. The results represent the lasting and continued rejuvenation effect of fat transfer.
The Treatment: One of the old dictums in plastic surgery is
"replace like with like." When it comes to facial volume loss, micro fat transfer is the
treatment of choice. A gentle liposuction technique is used to prepare the fat for transfer.
Then the fat is then injected in the desired portion of the face, using a micro injection
technique. This approach allows extremely small parcels of fat to be placed into multiple
layers of the face. This maximizes potential survival and allows for optimal aesthetic
outcome. In my practice this is done most commonly around the hollows and grooves of the
lower eyelid region and cheeks. Another common area is around the mouth and jawline. It can
also be done throughout the entire face giving the entire face a natural rejuvenation.
A photo of a woman who underwent fat transfer to correct her flat midface
and lower lid region. Note the enhanced and youthful contour of her cheeks and most importantly
the durability and persistence of the fat after 3 years.
Anesthesia: The procedure is most commonly performed under
local anesthesia with a light oral sedation. Patients go home the same day with little
discomfort and essentially no downtime. Bruising is variable.
Expected Outcomes: Generally, 40-60% of the transferred fat
persists permanently. Although, the long-term efficacy of transferred fat has been documented
in numerous studies results are extremely technique dependent. I encourage all my prospective
patients to speak to past patients and ask them what their experience has been with the
Post operative Course: Other than a very small incision at the
fat harvesting site, no incisions are made in the face. The most common post procedure issues
are swelling and bruising. This is often minimal and often resolves in a few days. Patients
usually return to normal activity within a week. The more regions of the face that are treated,
the more time it takes for the swelling to settle.
Sculptra is used to treat the same problems as mentioned above. It is not a true
filler. It is a unique product that is actually works by stimulating collagen production in the
deep layers of the skin. The results are similar to fat transfer hence the term "fat in a bottle."
The treatments are performed in the office setting. It takes 3 treatments spaced 4-6 weeks apart.
The changes occur slowly, leaving friends and loved ones wondering what is responsible for this
positive change. We also use Scultpra as part of our Liquid Facelift technique.
I often recommend this for patients who are very thin and don't have enough body
fat to allow for successful fat transfer. Or for patients who simply choose this approach over
fat transfer once they've heard the pro's and con's for each treatment.
Restylane/Perlane and Juvederm
These are true fillers. They consist of Hyaluronic Acid, a natural product
aboundent in our body. Unlike fat transfer and sculptra, which are often used to treat broad areas
of facial volume loss, these products are used to target specific discrete areas. For example, the
nasolabial folds (cheek folds), lips, and corners of the mouth are common areas for treatment. More
advanced uses of these products are for treatment of the hollows and grooves around the eyes. The
results are excellent and last between 6-9 months, depending on the treatment site.
Radiesse consists of Calcium Hydroxyappetite. This office-based fille is used to
treat deep folds, grooves and hollows. The most common uses are to treat the nasolabial folds and
to add cheek volume. The results last 6-9 months.
Dr. Karam, who is board certified by the American Board of Facial Plastic and Reconstructive Surgery and American Board of Otolaryngology, offers services in San Diego County including San Diego, Del Mar, Carlsbad, Carmel Valley,
Encinitas, Rancho Bernardo and La Jolla in Southern California. If you are ready to schedule an appointment for a fat transfer with Dr. Karam contact us today. 858-259-3223
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Dr. Karam voted "2010, 2011, 2012, 2013 Best Cosmetic Surgeon"
Ranch and Coast Magazine
Readers Choice Award