Fat Grafting(Lipofilling)

One of the important changes that occur in the face as we age is soft tissue loss. This is particularly noticeable around the eyes and in the midface region. In addition, the subcutaneous tissue weakens and the skin becomes thinner. The tear troughs, nasolabial lines and marionette lines deepen. Fat injections can be performed on any patient past middle age whose face has a generally worn appearance. Apart from this, in patients who structurally have a flat midface, a retruded chin tip and a weak jawline, facial contours can be changed with fat injections.

The areas of the face where fat injections are most often given are the temples, around the eyes, the upper eyelids, under the eyes, the midface region, over the cheekbones, the tear troughs, the nasolabial lines, the marionette lines, the lips, the chin tip and the borders of the lower jawbone.

Fat injection has two effects. The first is the filling effect, and the second is the regenerative, that is, renewing, effect.

• The filling effect is provided by the fat cells that continue to live at the injected site and by the new cells formed through the transformation of stem cells. Thanks to this effect, the facial contour is changed and deep lines are filled. The cheekbones, lips, chin tip and jaw contour are corrected with this effect. The edges of the eyebrows are made more defined and the area around the eyes is filled.

The renewing effect is provided by the injected stem cells. These transform into the missing connective tissue elements and fibroblasts and increase collagen synthesis. A general rejuvenation and refreshment of the skin occurs. Thinned skin becomes fuller, dry skin becomes moisturised, and fine wrinkles and spots decrease. In addition, the applied stem cells also increase the amount of vascularisation in the skin, contributing to the skin becoming more lively and radiant.

Adipose tissue is harvested from any part of the body with the help of special thin cannulas and syringes. The harvested fat is purified by centrifugation or filtration. It is injected into the required areas of the face using thin cannulas with blunt tips.

As with all operations, for facial fat injections aspirin and smoking must be stopped 3 weeks before surgery. In the last 1 week, it is necessary to stay away from drugs and similar substances that may thin the blood.

Things that should not be used:

• Painkillers such as Apranaks, Voltaren and Vermidon (when a painkiller is needed, Minoset or Novalgin can be used),
• Multivitamin pills containing substances such as ginseng, ginkgo biloba and coenzyme Q,
• Green tea, flaxseed, cherry stalk, tomato seed, herbal products
• All slimming products

Facial fat injections are performed in an operating theatre and under heavy sedatives (sedation); general anaesthesia is often not required.

Although it varies depending on the areas to be treated, the procedure takes about one hour.

Fat injections are not painful procedures. Patients are bothered more by swelling and bruising.

Patients are generally sent home on the same day. There may be some swelling and bruising in the first 2 days. To reduce this, ice is always applied in the early period. Patients can go out wearing glasses as early as the next day. The bruising and swelling begin to decrease after the third day and have largely subsided by the end of one week. If bruises remain, they can be hidden with the help of concealing make-up. After about 3 weeks the face largely returns to normal. Patients need to protect themselves from the sun for 3 months after surgery.

Fat injections are safe procedures, and not many problems are expected. In injections around the eyes, if sufficiently finely processed fat tissue is not used, lumps and hardness may form under the skin. If excessive amounts of fat are injected into the midface, exaggerated results may occur. Swelling in the lips is considerable, but unfortunately the resorption rates are also high.

In the past, it was thought that all of the injected fat was lost. However, when fat is harvested with the right techniques, prepared appropriately and injected into the face with a correct method, the rate of permanence is very high. It can be said that all of the fat injected around the eyes remains. The take rates are also high in the midface, the chin tip and the jaw contours. Losses are greater in mobile areas. While only half of the fat injected into the nasolabial lines remains, loss rates in the lips are high. However, it can be said that the restorative effects of fat injections are permanent.