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Fat for Facelift: The New “Liquid Gold”

Adipose tissue, or fat, has long been considered an unwanted waste product and simply discarded as medical waste. Times have certainly changed… fat is now considered the new liquid gold! At an increasing pace, plastic surgeons are using fat to restore and reshape areas such as buttocks, hips, breasts, male pecs, calves and the face.

Fat and Facial Rejuvenation

Fat appears to be the missing link in facial rejuvenation, accomplishing far more than meets the eye. Extensive research has established that as we age, our faces lose volume from depleting bone density and lose fat from multiple deep compartments. In a simplified description, aging skin reveals a reduced vascular and glandular network, declining collagen synthesis and elastosis (degeneration of elastic tissue), leading to the reduced thickness, strength and elasticity of our skin. This deterioration in skin quality, combined with the loss in facial volume, causes the skin to sag, thereby producing the pronounced lines and wrinkles of facial aging.

Fat and Facelift

Many plastic surgeons are now appreciating that even with the best facelift techniques, for many patients, optimal facial rejuvenation cannot be obtained without restoring lost volume. More recently, research has revealed that fat not only can be used to counteract volume loss and restore a more youthful facial structure, but that it also aids in the actual structural and physiological rejuvenation of the skin itself on a cellular level!

Harvested fat, after a simple process of being placed in a centrifuge, produces a small pellet at the bottom called the stromal vascular fraction (SVF). This SVF contains a large population of stem cells (adipose-derived stem cells), as well as a whole host of other beneficial cells including progenitor cells, T cells, B cells, mast cells and macrophages all important for regenerative and therapeutic applications.

A combined study out of the University of Verona Italy, Clinica San Francesco; and the Postgraduate Program in Surgical Science, Federal University of Rio de Janeiro, published in Plastic & Reconstructive Surgery, April 2015, presented clinical evidence showing actual skin rejuvenation after fat grafting which included the stromal vascular fraction (SVF) adipose-derived stem cells.

This study also suggests the more simple process of using a centrifuge is just as effective as the more complicated and expensive methods of obtaining stem cells through complex and time consuming culturing. Skin samples from this study revealed formation of new blood vessels and production of young elastic fibers and improved dermal architecture. Continuing studies are also describing the improvement in skin quality, texture and elastic condition, as well as the improvement in all types of scars.

After personally seeing the dramatic impact this procedure has had on many patients, fat transfer to the face has quickly become a routine weekly procedure for Dr. Gershenbaum. Transfer results are especially dramatic when used in combination with a facelift. After seeing the benefits of fat transfer to the face, it is not uncommon to hear, “I love it, when can we add more?!”

Many more studies are sure to follow with even more precise determinations of the cause and effect of fat and stem cells on the rejuvenation of skin. For now, fat is the new “liquid gold” for plastic surgeons, and the “natural” way to add shape and volume here, there and almost everywhere.