Botox and Restylane have become the mantra for those seeking facial rejuvenation without the inconvenience of having a “surgical procedure.” While these off-the-shelf products are enticing, they are expensive, temporary, and can be painful to inject, especially in the lips. For more Plastic Surgeons, these artificial fillers (Restylane, Juvederm, Strattice) are appropriate only for temporary improvements where there are time constraints and the need to be in public within a couple of days. Searching for the perfect facial filler had been elusive until recently. The emergence of fat from your own body (autogenous) has paralleled the refinements in fat harvesting and injection techniques that have elevated the “take” of fat injections to the 80-90% range. Coupled with improvements in local anesthesia and anesthetic agents make the overall experience with the new fat injection techniques less painful and more likely to give a permanent, elegant improvement in facial contours and rhytids (wrinkles). Many non-surgical practitioners complain of the donor site for obtaining the fat. While we must respect the donor site, offering the patient an improvement in body contour by harvesting fat for injection offers the patient the benefits of a liposuction (method of harvesting fat) procedure and cosmetic improvement of the donor site as well as the areas of the face injected with fat.
What does the future hold for facial fillers? Ongoing research using stem cell and growth factor technology may lead to even further improvements in fat injection techniques while artificial filler research tries to make their artificial substances last longer and the cost with longer lasting substances is naturally higher and will continue to increase over time.
Fat injection techniques have proven to be a vast improvement over foreign-body injections for facial rejuvenation. Fat is permanent, soft, cannot be rejected by the body, natural, and requires only small (3-4mm) stab wounds for injection. The patient can request which body area is preferred as a liposuction donor site obtaining body contour improvement at no additional charge. The well informed patient will usually choose the elegance of fat injection over the expediency of foreign material injected in the face.
As an extension of fat technology, we have begun fat injections in the back of hands for hand rejuvenation. The injected fat decreases the appearance of prominent veins, knuckles, and tendons that become more pronounced as we age. No one should let their hand reveal their age when we have the procedures to reduce the signs of the aging hand.