Structural Fat Grafting
Patient 1 (Cheeks)
This patient had structural fat grafting of her cheeks, or malar areas. If you look at the contour of her right cheek outline you can see the difference from before on the left and after on the right. Where the cheek was once flat it is now full which not only gives a more youthful appearance to the cheeks but also to the lower eyelids as well.
Lack of volume in the cheeks is not only a result of aging but is sometimes an inherited trait. This young patient has very little fullness in her cheek bones. This can be seen in the photo on the right. Her right cheek outline flows straight down from her lower eyelid with no curve at all. A visible hollow can be seen on her left cheek under the eye. In her after photo on the left you can now see a prominent curve to her cheek and correction of the hollow appearance under the eyes. (Note, this patient also underwent rhinoplasty surgery).
Patient 3 (Chin)
Ten years ago I would have treated this patient’s weak chin with a chin implant. Instead she underwent structural fat grafting to augment the chin while at the same time lipo contouring of the neck and jawline to better accentuate her profile.
This older gentleman shows a combination of findings commonly seen with age, namely hooding of the upper eyelid skin, prominence of the lower eyelid fat pads, and severe atrophy or volume loss in the mid face. Although a face lift would have provided a more complete correction, treatment around the eyes was sufficient to give a very significant improvement. He underwent upper eyelid skin excision, lower eyelid skin and fat excision, and structural fat grafting of the mid face to better blend the lower eyelid and cheek.
This case demonstrates the benefits of combining lower eyelid fat removal along with structural fat grafting. As you can see in the before picture there is fullness or “bags” under the eyes. Just beneath the fullness is a depression that extends along the entire lower eyelid like a semi circle. As is often the case, the bags make the depression look deeper, and the depression makes the bags look fuller. My approach to correcting this problem is to remove the excess fat from the bags, and add fat just below so that the result on the right is a smoother, better contoured upper cheek and lower eyelid. This can be seen especially well on the side view.
This is a good example of the effectiveness of structural fat grafting in shaping the under eye area. In the before picture you can see a dark, sunken and tired looking appearance. The only procedure performed was placement of fat, transferred from the abdomen, to the under eyes. The result is dramatic. The tired look is gone and in its place a brighter, more vibrant appearance. The result is permanent, though as she ages she will lose more volume under the eyes as we all do.