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Facial Augmentation
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If you're considering facial augmentation, you may have a few
questions you'd like answered. Facial augmentation using fat grafts is
not a new technique - fat transfer techniques have been around since the
19th century. As early as 1893, free fat auto grafts were used to
increase the volume of soft tissues. Throughout the 20th century,
attempts were made to use fat as a 'filler', but it was not until the
1980's that the concept of atraumatic liposuction and fat micro grafting
was developed. However, refinement of the technique has led it to be the
procedure of choice for an array of problems.
You may choose to undergo facial augmentation for a number of
reasons:
- To correct facial scarring
- To enhance the size and shape of lips
- To reconstruct small contour defects
- To enhance the shape and form of the chin and cheeks
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What is autologous fat grafting? |
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Autologous simply means the grafts are taken from your own tissues.
Autologous fat grafting involves transplanting very small samples of
fatty tissue from one area to another on your body, usually to increase
volumes in deficient areas. |
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Why is it advantageous over other techniques such as synthetic
facial fillers? |
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While synthetic fillers (hyaluronic acid, collagen, etc.) have the
advantage of being available 'off-the-shelf', they remain chemical
substances that are gradually broken down by the body. Fat grafting
makes use of your own tissues, which eliminates any potential
complication associated with foreign materials.
Unlike the use of synthetic facial fillers, fat grafting does involve
a second surgical site, for harvesting the fat cells. However, as this
is usually from an area of excess, it is seen by many as an advantage.
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Can it be used in facial rejuvenation? |
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In many patients, fat grafting is an extremely effective means of
rejuvenating the face. It is often used in conjunction with other
techniques (chemical peel, Botox) to restore youth and vitality,
especially in patients with early signs of facial ageing but who do not
necessarily want a face lift.
By re-creating the pleasing curves and volumes of youth, it combines
the benefits of facial rejuvenation surgery with a relatively low-risk
procedure.
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How does it compare to a face lift? |
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In some cases, facial fat grafting may provide many of the benefits
of a face lift, but without the scars and at considerably less expense
in terms of risks and recovery. However, patients with excessive skin
laxity and jowling are less suitable for fat grafting alone and may
still require a face lift. The techniques are not exclusive, and are
often combined to give excellent results. |
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Can it be done under local
anesthetic?
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In smaller areas, fat grafting can be done under local
anesthetic,
which reduces the complexity of the procedure. In large areas, a general
anesthetic may be preferable, especially if the technique is being
combined with another surgical procedure. Fat grafting alone is always
suitable for day case surgery.
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What takes place during the surgery?
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Fat cells are harvested from an area that offers 'spare' volume, such
as the abdomen or thighs in most instances. These are drawn up in to
small syringes, and then spun in a centrifuge to purify the cell layer.
The cells are then injected into the area to be augmented, by laying
down very thin columns of grafts along tunnels that are no more than 1
mm in diameter.
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Are there significant scars?
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No. Very small 'ports' are used to access the deeper tissues for
laying down the fat cells. While several small scars may be necessary to
obtain a good result, they are no more than 2-3 mm across, and usually
hidden in naturally occurring facial lines and become imperceptible with
time.
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I have heard that some of the fat disappears with time - is that
true? |
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Yes, because a percentage of the graft will not retain its volume, a
slight excess of cells are usually transferred. In some cases, a repeat
procedure may be necessary. However, the simplicity of the technique
means that this surgery is well tolerated. Some patients retain fat
grafts better than others, and the procedure may occasionally need to be
repeated. |
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I have a dark mole that has been present for a long time, but now seems
to be getting bigger. Does it need to be removed? |
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Many of us have numerous pigmented lesions on our skin, most of which are
completely safe to leave alone. Occasionally, the characteristics of a
lesion may change, and it needs to be examined by a doctor to exclude
malignancy. Some lesions may need to be excised and sent for histological
assessment.
If you are concerned about any pigmented skin lesion that you are
increasingly 'aware of', whether because of itching or change in color, you
should contact a doctor immediately.
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