SURGICAL FACIAL CONTOURING

GENERAL CONSIDERATIONS

Many age-related changes in the face and eyelids are the result of fat deflation (diminution of fat volume). This results in a diminution of the normal contours of our youth. Lost volume can be restored through volume enhancement - either through the use of injectable fillers (Restylane, Juvederm, Radiese) or surgical introduction of fat via fat repositioning/transfer or fat injections. Fillers have the advantage of being non-surgical and less invasive. Fat introduction has the advantage of greater permanence.

Fat introduction through repositioning/transfer or injection, along with placement of facial implants are not usually performed as an isolated surgery. Rather, they are often used as an adjunct during other cosmetic or reconstructive procedures.

Fat transfer (autologous fat transplantation) plumps abnormally deflated facial features with a patient's own fat. It is a safe, natural, non-allergenic procedure that can help recontour and bring definition to your eyelids, and cheeks.

SURGERY

Fat is usually harvested through a small incision at the umbilicus (belly button). It is then processed and irrigated with an antibiotic to prevent infection - in preparation for its transfer. The fat may then be placed into deflated areas of need such as the eyelids, tear troughs, cheeks, or nasolabial fold. This procedure is performed under either local anesthesia with intravenous sedation or under general anesthesia on an outpatient basis.

An alternative technique in the lower eyelid can more simply reposition the orbital fat that is already president and evident in the lower lid. Such repositioning can fill in the hollow areas located at the junction of the lower lid with the upper cheek, and can also fill the inner aspect of the lower eyelid (the tear trough).

AFTER SURGERY

Cold compresses are applied to reduce swelling and bruising. Antibiotic ointment will be prescribed. Strenuous activity should be minimized for several days. Discomfort is generally mild. Non-aspirin pain relievers are usually all that is necessary postoperatively. Aspirin products, non-steroidal anti-inflammatory medications like ibuprofen, and other blood thinners should be avoided before and after surgery as they may increase the risk of bruising and bleeding. Most patients are able to return to regular activities within several days.

RISKS AND COMPLICATIONS

Excessive pain, bleeding, infection, or vision loss are extremely rare and have never occurred in any of Dr. Kohn's surgeries. As with any medical procedure, there may be other inherent risks that should be discussed with your surgeon.

CONCLUSIONS

Dermal fillers are a minimally invasive means of adding fullness and volume. Fat transfer and fat repositioning are surgical enhancement that can provide a more lasting youthful appearance.