Thank you for your question.
You’re asking a question about having potentially fat grafting to the cheeks and the lips but
you have a concern due to a particular diet regimen where you eat one meal a day and you
have a perception that it’s likely that fat would get absorbed very rapidly.
And you’re asking about alternatives.
Well, certainly I can share with you my experience with this type of question which comes up
in different variations in our office particularly as it relates to diets.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
And essentially, the evolution of solutions for this type of augmentation has really been
a tremendous benefit for my patients and I’ll explain further.
To begin with, prior to 2005, before Restylane came on the scene, the search for the ideal
filler for a surgeon was essentially trying to do fat grafting.
We were basically working very hard and a lot of leading innovators with fat grafting
were essentially mentors to all of us to learn the art and science of fat grafting.
And certainly, fat grafting does have potential benefit.
But as time went on and even to this day, my major frustration with fat grafting is
predictability.
The challenge with fat grafting is that still, 30-70% of the fat can be absorbed.
And really, when we talk about fat grafting, we’re talking about fatty tissue which means
it’s a combination of fat and other parts of the tissue when you do liposuction.
Now, yes, there are many more refinements in the fat refining process these days.
But I would like to point out that for a lot of our patients who live and work in New York
City and in tri-state area, their lives are very busy.
Very often they have similar types of diets.
They can be very low carb, they can be vegan and they exercise a lot.
So, people who live very busy lives, work long hours, have very regimented diets and
have this type of lifestyle.
Essentially, you can get fat from them but at the same time, predictability is such an
important value.
So move the clock forward and we actually have injectable fillers which can provide
us with many of the things that we like about fat.
One limitation of any injectable filler is that it can’t last “forever”.
I say that in quotes because nobody lasts forever.
Everyone’s face continues to evolve and change.
And I see this in my practice when I see people who had fat grafting done 15 or 20 years ago,
they aged and there’s bone loss, there’s soft tissue loss.
There are various changes and it doesn’t look quite the same in not such a good way.
So we now have a wide range of fillers that allow me to essentially do correction such
as lip volume augmentation.
The fillers essentially that are predominantly used are all in the hyaluronic acid family.
And whether it’s the Juvederm family or the Restylane family, we really have a wide
range of options.
So when it comes to fillers, we’re looking at fillers at a point of view of being able
to achieve a particular result, being able to minimize any swelling and bruising so that
a person can get back to their normal life quickly and we want longevity.
And so, we do actually have many of the best of all worlds because one thing that is less
tolerated now than it was 10-15 plus years ago is inconvenience.
People have less time.
At least this is the impression I get in my practice regardless of which location we’re
at.
No one has time.
Everyone needs to look good for an important event in few days to like a few hours.
So it really is, we live in really time intensive lives.
So when it comes to fat grafting, there is a much longer period of healing and resolution
of swelling than with injectable fillers.
And with injectable fillers such as, let’s say you want to improve your cheeks, well
we use a technique called structural volumizing where augmenting and enhancing the cheekbones
can be done literally in minutes using techniques such as cannulas and a method that involves
placing the filler under the muscle using fillers that are long lasting such as Juvederm
Voluma.
You’re able to achieve a result that will give you, that can be very nicely refined
and predictably refined and it can be placed in minutes and it can last over a year up
to two years.
So for a cheek augmentation, it’s really fantastic.
For lip augmentation, it varies.
It depends on what type of lip augmentation you need.
But generally speaking, comparable methods using cannulas is my preferred approach to
minimizing the swelling, minimizing bruising and getting very nice natural looking results.
So whether you’re a young person looking to enhance or augment your lips or a person
who is, let’s 35, 40 or over, who’s trying to restore lost volume, these procedures can
be very convenient and predictable and certainly, achieve what you want.
I think that from my perspective, even though I haven’t seen your photo, I would suspect
that likely if someone like yourself comes to my practice, we have this type of discussion
so you can be informed and make an appropriate choice that’s right for you.
So I hope that was helpful, I wish you the best of luck and thank you for your question.