Fat Grafting Part I – Rejuvenating the Eyes

In these tough economic times we all need to “cut the fat.”  Okay, everyone in real businesses – clearly not the government.

But instead I propose moving the fat, and transferring it to the face.  Remember, fat is youth. The economy might be bad but at least we’ll look younger and more rejuvenated.  After all it’s better to look good than to feel good.  Oh bull, we’re going to to look good and feel good!

The science of periorbital (eyelid) rejuvenation has gone through several distinct transitions.  Initially it was all about removal of skin and fat.  Usually with removal of as much fat that could be teased out.  This lead to good results initially but a hollow appearance as the patient aged.  The surgery was based on only a limited understanding of the full anatomy of the eyelids.  As science has evolved, a much more complete understanding of the various muscles and fatty tissues has been discovered.  Now we are much better equipped to attack the aging process.

About 20 years ago a NY surgeon named Dr. Sydney Coleman began harvesting fat (liposuction) from one area of the body and injecting it into other areas, specifically the face.  Eventually he developed his own aspiration and injection cannulas.  This technique was slow to catch on with many surgeons because of the “take rate.”  Meaning that when the fat is injected blood vessels must be reintegrated into the existing fat in order to remain alive.

Unfortunately, with a large mass of fat it’s difficult for the vessels to grow in and therefore a lot of the fat dies and is reabsorbed by the body.  It’s not good to do a procedure that doesn’t work well.  It’s bad for business.  As time went on the cannulas improved (2.omm) and the technique improved.  Today most surgeons, with a  little experience, can achieve acceptable results after about two injection sessions.

But who wants to go through two procedures?  More recently Dr. Patrick Tonnard of Gent, Belgium has helped me appreciate that the smaller the cannula the smaller the aspirated fat.  And, with multiple level injection with this small fat product we can get a better “take rate.”  With this in mind I’m having custom made aspiration cannulas at 1.4mm and 1.6mm and infiltration cannulas of 1.2mm made specifically by Wells-Johnson for the eyelids and face.

pat-hanretta-pre-op-left-eye-for-blog1left-eyeAs you can see in the pictures, the youthful eye on the right has much more fullness (fat).  The aging eye on the left needs this fat to reduce the the depression under the bony orbital rim (she needs other things as well but you’ll have to see the previous blogs for them).

A few CCs of small fat product injected under the eye muscle will drastically change this patient’s appearance.

Let’s talk about rejuvenating your eyes, with eyelid surgery or fat transfer – whatever is best for you.  Call my assistant Katie at 703.752.6608 for your consultation.

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