Fat Infiltration

Facial restructuring with lipostructure

Lipostructure is a term which refers to augmentation and contouring of the face using the patient's own fat. Whilst fat infiltration has been a popular procedure for many years, techniques have become more refined. The modern technique was first described by an American plastic surgeon by the name of Sidney Coleman in 1997. This technique involves the transfer of fat from a region in the body such as the abdomen or thighs and transplanting it into areas in the face to augment or recontour the face. Previous techniques of transplanting fat into the face were often less than satisfactory as most of the fat would be reabsorbed. In the technique described by Sidney Coleman, this problem has been solved. The essential difference being that the fat is transplanted in tiny droplets and laced into the skin and underlying structures to gradually build up the contour where it is desired.

In practice the technique is most useful in replacing the fat of the face which either decreases over age or drops due to gravitational effects. The is usually apparent at the cheeks or underneath the cheek bones, or underneath the eyelids. In actual fact, shrinkage of the fat is largely responsible for the laxity of the skin that is observed during ageing. The technique is an alternative to face-lifting. Certainly there are some advantages to this lipostructure over face-lift surgery as the natural contours of the more youthful face can be duplicated with better definition.

The technique is however very labour intensive. It is best done under intravenous sedation or general anaesthesia.

It involves removing fat from an area such as the abdomen or thighs where there may be an excess of fat. The fat is then refined and centrifuged. It is then reinserted into the face through tiny punctures and then laced into the structures of the face in layers to gradually build up contour. It can be used to augment the lips and to hide the lower eyelid bags. In the upper eyelids and brow area, it is useful to lift the brow and reduce eyelid hooding. Sometimes this will obviate the necessity to have upper or lower blepharoplasty or even a forehead lift.

Depending on the amount of fat infiltrated, the procedure may take as little as half an hour or as long as 2-3 hours. You will be comfortable during the procedure and have no recollection of it afterwards with the type of anaesthesia that is used. Furthermore it is generally not painful at all following the procedure. The tiny puncture marks heal well. Small stitches may be placed which will be removed in five days. The wounds heal without a visible mark in most instances.

The only post-operative complications that are generally seen are swelling, which may be quite marked over the first week. It will gradually subside over the next week or two. A bruise may eventuate if a small vessel is struck with the blunt instruments that are used. This is usually not severe and will resolve over the course of a week or two. Infection is extremely rare and you will be covered by oral antibiotics. It is possible that a nerve may be struck with the blunt instruments and this may result in some numbness or even loss of function of some of the muscles of facial expression. This is temporary as the instruments are blunt and it is extremely unlikely that any nerve would be permanently damaged. Once the swelling has resolved completely, the contour of the face will become more apparent. Generally however, the final results of the restructuring process are not viewed and judged until three months.

In summary, this is a very effective procedure for restructuring or recontouring the face using your own fat. There is no chance of any allergic reaction to your own fat and the overall safety profile of this procedure is excellent.

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