Facial aging occurs due to two factors; loss of fat, and loss of skin elasticity. It's that simple. Gravity does not play a role in aging. It only affects the way we look as we age. The fact is, as we age, fat that once filled the face diminishes. Thus the skin gets closer to the skeleton. When the skin loses its elasticity, and can no longer compensate for the loss of fat, the skin begins to sag. In order to restore the natural, youthful appearance of the face, we must restore the skin in three dimensions. . In the past, facial cosmetic surgery addressed the loss of elasticity, but paid little attention to the loss fat within the face. The traditional face lift procedure lifts the skin up and pulls it back, which ultimately pulls the skin closer toward the skeleton. This is why many people after face lifts look tight, and not very natural. The youthful face is also full, and the skin is not close to the skeleton. With the "3-D lift", fat is harvested from another part of your body and artistically grafted into the face. This grafting lifts the skin away from the skeleton restoring the fullness lost. The result is a naturally youthful appearance.
New techniques in the way the fat is harvested and placed have greatly improved the survival of the transplanted fat. Advances in technology and techniques have allowed us to maximize the outcome of fat grafting. In fact, Dr. Mark Berman, (Los Angeles, CA) my mentor, and considered by many to be the foremost expert in modern day fat grafting, has patients who's 7 year post operative follow-ups demonstrate continued survival of the fat. The harvested fat is also richly bathed in Stem Cells. This may explain why patients tend to notice improvement of their skin quality after fat grafting. As I stated, this is a very technique sensitive procedure and its outcome is based not only on surgical skill, but on the artistic ability of the surgeon (the ability of the surgeon to accurately understand how your face has aged, as well as where and how to place the fat.) I feel very fortunate to have learned this procedure from the leader in the field, Dr. Berman.
The initial signs of aging usually present as subtle changes around the eyes. With a true understanding of how the face ages, fat grafting should be the first treatment for the aging eyes. Traditional cutting and removal of skin (blepharoplasty) should be reserved for the rare cases when filling is not enough. This is usually the case in older individuals (60+), or patients who have always felt they have "heavy" eye lids and desire a different shape. However, most patients who want a "rejuvenation" procedure do not want to look different. Rather they want to look like they used to. We suggest you bring photographs of yourself to your consultation so that we can compare these pictures to your current appearance.
If there is too much sagging skin (due to the loss of elasticity) for a "3-D lift" (fat grafting) alone to compensate, then a lifting procedure may be added. Today a face lift can be performed through a short incision, the "Weekend Lift." This incision follows the natural curve of the ear, and rarely extends behind the ear. All these procedures are performed in our out-patient surgical center.
The "3-D lift" (fat grafting) helps to naturally set back the clock as it replaces fat that was lost. As with the original fat, this fat will eventually metabolize, and therefore is not permanent. Some surgeons prefer permanent implant materials claiming a permanent result. However, our body will always metabolize and lose our facial fat. This may eventually leave the implants noticeable as well. Therefore eventually fat, or some other filler, will be needed to replace natural losses that result in signs of aging.
Cosmetic surgery for men is not as socially acceptable as it is for women. However, men too want to look as young as they feel. As men work into their later years of life, they have to compete with a younger work force. The "3-D lift" is a great alternative for men. Due to the lack of visible scars, the "3-D lift" gives men the opportunity to achieve a younger appearance while avoiding the social scrutiny of having cosmetic surgery.
While fat grafting may be the most artistically demanding of all surgical procedures, the "3-D lift" provides the patient the opportunity to naturally restore their youthful appearance without looking surgically altered or even demonstrating the signs (scars) of surgery.