Lipofilling: Fat – The liquid gold

Fat injections have been used for some 20 years to correct areas in the body where there is a volume shortage. This technique can not only be used in the face but also in other parts of the body such as hands, breasts and buttocks!

Our own fat can be injected into a breast that is too small, a buttock that is not in good shape or a face that looks worn out/old/tired/deflated. Having learnt from the masters of fat grafting themselves (Dr. Tonnard and Dr. Verpaele of Coupure Centrum and EMC2 fame), this technique is applied routinely in many of our cosmetic procedures today.

The aging process in the face is almost always accompanied by loss of volume (fat) around the eyelids, cheeks and around the mouth. The classical eyelid correction consisted of surgical removal of skin and adipose tissue. This often led to hollowed-out eye in the long term that did not resemble the eye that the patient had at a young age.

A new technique to rejuvenate eyelids in a more natural way, by adding fat in certain places in order to obtain the full aspect of the eyelid in the youth. Often a limited skin resection is also performed. The results obtained in this way are much more natural than the classic ‘blepharoplasty resection’. This technique is referred to as “Augmentation Blepharoplasty”, practised exclusively in few centres in Europe and US.

The cheekbone region also sees a volume loss due to aging, even in people whose body weight has increased over the years. Fat injections with very good results are also used here to rejuvenate this malar region.

‘Atrophic’ changes often occur around the mouth. This means that loss of volume is also seen here in the ‘nasolabial’ fold (the fold on the transition between lip and cheek) and in the global volume of the lips. Also often stubborn vertical lines on the upper and lower lip (so-called ‘barcode’). This is remedied with fat injections in various ways.

The fat required for lipofilling is sucked away via keyholes using a small tube (“cannula”) from a zone where you can miss some fat accumulation such as lower abdomen, inner thighs (called donor areas). The fat is processed and inserted, all in a sterile manner, through puncture holes under the skin of the face or the area where it is needed.

There the fat cells have to get oxygen and nutrition again in order to be able to grow. Part of the injected fat will melt away during the 3-4 months following the treatment. Due to this “microfat grafting” technique, approximately 70-85% of the fat will be retained.

Fat grows better in the face than in the breast because of better blood supply. In the face we see more growth in immobile zones such as temples than in mobile areas such as lips. It is therefore necessary to inject more during the treatment in certain zones (overcorrection) in order to arrive at a definitive result after the period of resorption. However, in the face we generally avoid ‘overcorrection’ to obtain natural results.

The take home message here is: Fat is the new filler!


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