Ideal anatomy and proportions:
A young face is defined by an overall “V” shape given by full cheeks and well-marked cheekbones associated with a well-defined facial oval.
The aging of the face is due to a sagging of the skin: the face sinks downward with the appearance of nasolabial folds and jowls “marionette lines. This loss of elasticity leading to sagging skin is combined with a melting of the various fatty areas of the face over time, which leads to a loss of support.
This loss of volume can be restored with a fat injection (= “lipofilling” or “nanofat transfer”). Fat behaves like a permanent hyaluronic acid by its volumetric properties but also induces skin rejuvenation, because it contains growth factors, cytokines and stem cells that induce a secretion of collagen and elastin, correcting pigment spots, fine lines and improving the texture, elasticity and hydration of the skin.
The different sites of fat injections:
- Creation of projection to harmonize: lips, cheekbones, chin, jawline, nose
- Restoration of lost volumes: temples, forehead, brow bone, dark circles, nasolabial folds, superficial wrinkles around the mouth and on the neck
- Superficially as a “skin booster” to work on the skin’s texture
- But also in the breasts or in the buttocks
A loss of 20 to 40% of the injected fat will occur, and almost 80% in patients who smoke. In order to survive, the fat must be integrated into the site where it is injected. Tobacco alters the microvascularization and limits the blood supply to this fat. This is how we will aim for a minimal hypercorrection when injecting fat, because we know that 20 to 40% of this fat will be resorbed.
Technique:
Fat removal (often internal knee or abdomen) under local anesthesia (no pain with an adapted anesthesia), decantation and specific preparation of the fat (thus recovering part of the purified fat, rich in stem cells) then reinjection with a microcannula via entry points > 1 mm
Results:
Time frame final results:
1 week for the filling, but 3 months for the rejuvenation effect on the skin of the stem cells contained in the fat
Longevity results :
5-10 years
Before the operation:
Stop smoking 1 month before lipofilling.
Do not take Aspirin 10 days before surgery, inform Dr. Lucas of any anticoagulant medication (Sintrom, Coumadin, Eliquis, etc.) in order to arrange for its discontinuation or replacement.
Take Arnica capsules 5 times a day for 5 days before surgery to prevent hematoma.
Intervention :
Pain: the pain during the intervention will be almost non-existent, with an adapted anesthesia
Duration of the operation :
Anesthesia: local
Location: operating room
Ambulatory (without hospitalization)
After surgery:
Post-operative pain: 1/10 often responding to Dafalgan
Social eviction :
Lipofilling: swelling and bruising for 4-7 days
Suture removal: no sutures
Return to work: 2-3 days
Return to sport: 2-3 days
Instructions:
Bed rest without major effort and ice mask for 2-3 days, as often as possible, to reduce swelling.
Do not compress the fat injection area (risk of fat loss)
Take Arnica capsules 5 times a day for 5 days after surgery to prevent hematoma
Lyman 50,000 IU 3 times a day cream on fat collection areas to accelerate the disappearance of hematomas
Stop smoking permanently to prevent fat resorption
Control Dr Lucas 2 weeks, 3 months
Complications:
– Infection, hematoma, asymmetry, under or overcorrection
– Intravascular emboli: it is important to have this procedure performed by a qualified surgeon who is used to injecting. A vascular embolus if it moves into the circulation of the retina can lead to blindness or necrosis.
Alternatives and operations that can be combined:
Lipofilling can be combined with a minilift or facelift to enhance the result.
