Facial Volume Replacement: Rejuvenation through Fat Injection
Volume replacement is an increasingly popular choice for cosmetic surgery. In short, volume replacement is a process by which areas in which fat has been depleted due to injury or the natural aging process are replaced with injected materials, filling out hollowed or sagging areas, and creating a taut surface for the skin.
Any number of materials are available to cosmetic surgeons for volume replacement, including silicone and other synthetic materials, as well as natural materials such as collagen; but one of the safest and most common materials used for volume replacement is fat removed from the patient through liposuction, whether as part of another cosmetic surgery procedure or done solely for volume replacement purposes. Once removed, this fat is strategically reinjected into the face to fill out hollowed or wrinkled areas, leaving the patient with smoother, healthier-looking features.
The results of facial volume replacement are, in many ways, similar to the results of a facelift, in that the added fat lifts the skin and can be used to resculpt the facial features, creating a more vibrant, youthful appearance.
What are the Benefits?
Facial volume replacement can be used for a number of cosmetic purposes, including the following:
- To fill in nasolabial folds, or the ‘laugh lines’ that run from the nose down to the corners of the mouth.
- To fill in hollowed areas in the cheeks or under the eyes from loss of facial fat as a result of aging.
- To enhance thin lips.
- To enhance the jawline and cheekbones.
Because the cosmetic surgeon injects fat from the patient’s own body, risks of allergic reactions and other problems are minimal.
What are the Drawbacks?
The effects of volume replacement are not permanent, and depending on the rate at which the patient metabolizes the fat, repeat treatment may be necessary to maintain optimal results.
Also, while areas treated are ‘overfilled’ to accommodate reabsorption of some of the injected fat, different people reabsorb fat at different rates, so in some patients, fat is reabsorbed more quickly and more completely, requiring additional treatments. Areas that most often require repeated procedures are the nasiolabal folds, or ‘laugh lines,’ and the area between the eyebrows. Areas with greatest fat retention (which subsequently require repeat treatments less often) include the cheeks and lower eyelids.
How is the Procedure Performed?
Facial volume replacement consists of two basic steps.
In the first step, fat is removed through tumescent liposuction, a liposuction process performed under local anesthesia that allows fat to be removed with far less bleeding and bruising than traditional liposuction procedures. The liposuction is performed on an area with sufficient excess fat to accommodate the volume replacement—usually the hips, stomach area, or the thighs. The fat is then purified and prepared to be reinserted.
The second step is to reinject the fat. During this step, also performed under local anesthesia, the surgeon reinserts the fat, small amounts at a time, into the area to be filled out.
The recovery process usually involves minor swelling and bruising, which should subside within a couple of days.
Howard Rosenberg, M.D., a plastic surgeon in the San Jose – San Francisco area has experience with facial volume replacement and fillers like collagen.