Aging causes loss of soft tissue support and sagging of the skin. Face fat grafting is a cosmetic surgery procedure that deals with the grafting of autologous fat to the face, also known as ‘Fat transfer to face’ that helps in restoring the facial contours. This face fat grafting procedure restores the lost volume and also helps in correction of depressed scars and creases. Face fat grafting is performed by harvesting and transferring fat from one part of the body such as the abdomen or thighs and injected to the face. This technique of fat transfer to the face helps in filling the sunken eyes, acne scars, injuries, etc. First step in the fat transfer to face technique is collection of the fat usually from the lower abdomen. This will also provide the patients with added benefit of liposuction. This fat has to be collected in a sterile syringe or a container and then has to go through a process so that it becomes suitable for grafting. Rather than using injectable fillers to fill the defects, fat transfer to face is a better technique as it does not need multiple sessions or touch-ups. Also, use of face fat grafting gives long- term effects as the fat develops a blood supply and becomes permanent.
Autologous face fat grafting, a process of harvesting one’s own fat cells, has become increasingly popular in recent years. It can be indicated in newer reconstructive modalities for breast and face, burns, congenital anomalies like hemifacial microsomia, facial contouring, post radiation and traumatic defects. It is often difficult to choose the ideal donor site for harvesting the fat. Donor site has to be chosen as per the patient’s characteristic, recipient site volume and healing implication. The donor site should contain highest concentration of mature adipose tissue. The common donor sites include the abdomen, buttocks, thighs, arms, etc. Many techniques have been introduced for harvesting the fat from the donor site. It can be done by using a vacuum assisted technique, syringe suction technique and surgical excision. Liposuction for fat transfer to the face is done in such a way that the harvested fat is clear of all unwanted debris, erythrocytes and derma appendages and the harvested fat has the maximum number of stem cells.
FAT PROCESSING FOR FAT GRAFTING:
Survival of the fat cells depend on the processing of the fat. More the concentration of the mature adipocytes, better the survival. Mesenchymal stem cells in the stromal component also helps in the survival and better surgical outcomes. The main reason for processing the fat for fat grafting is to remove the unwanted oil, cellular debris, non- viable erythrocytes or other hematogenous cells. More the blood cells, more will be the degradation of the grafted fat. The processed fat is obtained by Sedimentation, filtration and centrifugation. 2- 10 cc of Luer- Loc syringes are used to load the fat and then the grafting is done in the desired location through theses syringes.
FAT INJECTION FOR FAT GRAFTING:
Once the fat has been harvested, it is allowed to settle so that the tumescent fluid and blood cells are washed and removed. It is then taken in smaller syringes and made ready for injecting at the recipient area. A thin needle 0.9 mm – 1.4 mm is used in the face for fat transfer to the face. The needle is inserted in the desired location and connected to a syringe containing fat for grafting. The fat transfer to the face is done in a retrograde manner as the syringe is moved in a fan shaped, fanned out or segmental pattern.
Far transfer offers a safe, natural and lasting solution for a more youthful appearance. Most people show improvement immediately after fat grafting. Sometimes, overfilling has to be done so as to compensate for the expected fat loss. The cells that are harvested at the recipient site fills up the scar tissue or the wrinkles and survive along with also promoting collagen production. This regeneration of the underlying collagen leads to permanent results. The effects become more visible and enhanced as time passes. It also helps in enhancing the collagen production. Although aging is a continuous process, however it can be delayed with the use of fat grafting in the wrinkled areas helping in achieving a rejuvenated look.
INDICATIONS:
- Depressed scars
- Rhytides and wrinkles
- Enhancing the cheek bone
- Defining the jaw line
- Traumatic defects
- Correction of sunken eyes
- Congenital defects
- Forehead, temporal and supraorbital hollowing
- Malar bags
- Nasolabial folds
- Thin lips
- Retruded chin
- Tear trough deformity
CONTRAINDICATED:
- Local, regional or systemic conditions affecting the blood flow
- Radiation therapy
- Keloid scarring
- Coagulopathies
- Immunosuppressive medications
COMPLICATIONS:
- Bruising, edema and ecchymosis
- Granuloma
- Oil cyst
- Blistering
- Scarring
- Fat embolism
- Stroke
- Blindness – RARE
NANOGRAFTS:
Nanofat is a new concept that helps in treating very fine lines and thinning of skin. The harvested fat is broken down into smaller pieces by a special device. The microscopic parcels of fat are further modified into Nanofat by passing through 2 screens of different sizes. Nanofat has been proved to reverse architectural changes in elastin and collagen thereby allowing regeneration of the tissue. Nanofat has also shown to improve hair growth in men and women in conditions like alopecia.
Nanofat can thus be used for fine lines, forehead rejuvenation, smoker lines around the lips (perioral rhytids), damaged skin due to UV radiation, deep and superficial acne and scars.
WHAT IS THE FACIAL FAT GRAFTING COST IN MUMBAI?
Since facial fat grafting is a procedure with long lasting results which adds volume to the area as well as improves the blood supply, it is worth the cost and much more as compared to fillers. In India, facial fat grafting cost ranges from 25,000 to 75,000 Indian rupees per area depending on the area and extent of procedure, surgeons experience and facilities offered by the hospital.