Fat Grafting

Fat Grafting

Faces age in many different ways and at varying rates. Today, there are a myriad of facial rejuvenation paths available to you, both surgical and non-surgical. Beautiful, natural looking results have replaced the tight, expressionless, “overdone” looks of years’ past. Sometimes a combination of procedures is necessary to achieve the results you desire. The time you spend in consultation with Dr. Lee will be very important in determining which procedures you might consider to meet your expectations.

“Facial rejuvenation is highly individualized and must be addressed holistically. It’s all about balance and harmony. I am eager to hear each patient’s focus of concern and determine the best way to improve what bothers them. Patients are very interested when I explain how the overall pattern of aging is specifically affecting them. Sometimes non-invasive treatments are all that is necessary. Other times we talk about how interrelated rejuvenation really is…for example, you have to be aware how performing a face lift will influence the lower eyelids. Doing isolated procedures can sometimes make other areas look out of proportion or obviously “older.” This is why our discussion in consultation is so important. I want what is best for each patient. If I can accomplish their goals and make them happy, then I am satisfied. They need to know I am going to take care of them throughout the whole process.” — Michael Lee, M.D.


Many patients undergo volume loss in certain areas of the face as they age. This is common in areas like the temples, cheeks, and even low face. Of these different areas, the cheeks are often the most significant. The loss of volume leads to a noticeable demarcation between the lower eyelid and the cheek. This area, called the “lid-cheek junction” is responsible for some of the most distinctive changes seen with age. A youthful face has a very smooth transition from the lower eyelid to the cheek. During the aging process, as the cheeks lose volume, this lid-cheek junction becomes more prominent. In addition to losing the volume, the volume that remains often drifts lower on the face creating the folds that we see with age. The result of these changes can make patients constantly look tired and stressed.

There are different ways to correct this loss of volume that occurs throughout the face. Such ways include both surgical and non-surgical treatments. There are benefits and trade-offs to each corrective procedure. Non-surgical treatments usually involve injection of fillers. Many different fillers are on the market today with each designed to achieve a certain goal of volume restoration. Fillers are a great way to restore lost volume but they do have downsides. Fillers are synthetic materials and most are temporary.

A very popular alternative to filler injections is fat transfer. The process of fat transfer involves liposuctioning fat from one area and transferring the fat to a new desired location. In the case of facial volume restoration, Dr. Lee usually harvests fat from the abdomen or thigh and then grafts that fat to areas the patient has selected. Fat transfer has the advantage of using the patient’s own tissue to restore their lost facial volume. Not only does fat transfer help restore volume but fat also possess additional rejuvenation properties. “The use of fat transfer has really provided surgeons with an important means of volume restoration in facial surgery. It’s a very helpful and artistic procedure,” states Dr. Lee


Any patient interested in pursuing facial rejuvenation or fat transfer should consult with a Board Certified Plastic Surgeon. Being certified by the American Board of Plastic Surgery means that patients are consulting with someone trained in both non-surgical and surgical ways to treat facial aging. Among Board Certified Plastic Surgeons, it is advisable to find someone with expertise in facial anatomy. Dr. Lee fulfills these criteria as he is not only board certified by the American Board of Plastic Surgery, but also by the American Board of Otolaryngology-Head and Neck Surgery. What this means to his patients is that Dr. Lee possesses a comprehensive expertise when treating the aging face. His expertise will be apparent during your consultation as he listens and addresses your concerns.

With Dr. Lee, patient education is very important. Our faces, and bodies for that matter, are not perfectly symmetric. Dr. Lee will discuss his findings during consultation and explain how these findings are important during fat transfer. “Fat transfer allows me to improve facial symmetries, refining the overall balance of the face. That’s the goal and fat transfer helps us achieve it,” says Dr. Lee


When performing any facial surgery, whether facelift, browlift, or fat transfer, Dr. Lee makes it a top priority to treat the signs of aging without changing the essence of a person’s natural beauty. He believes the goal should be to restore youthfulness while maintaining an age appropriate look. Dr. Lee emphasizes, “Fat transfer is not simply injecting fat into an area. It’s about analyzing where each individual patient is deficient and artistically repairing that deficiency. I want my patients to look rested and youthful. I don’t want them to have so much volume that they look different or “overfilled.”


Dr. Lee’s comprehensive level of facial knowledge and expertise place him among the elite in the specialty. “My approach to fat transfer is the use of time tested technique complimented by the most recent innovative advances. The field of fat transfer is constantly evolving as it should be. While fat transfer has plenty of advantages, we are still working on ways to make it better and more reliable.”

One of the primary challenges with fat grafting is getting the fat to live. Fat that has been removed with suction no longer has a blood supply. These fat cells will get new blood supply from the area where they are grafted. For this to happen they must be handled delicately. Dr. Lee stresses, “this is why technique is so important.’’ Gentle handling of the fat is essential at all times. The volumes used in facial fat transfer are small and every cell counts. Not only how the fat is harvested, but how it is placed is important. “Every aspect of fat transfer is vital to the overall aesthetic outcome and the technique must reflect that fact.”


How faces age and what we can do to fight facial aging

There has been a paradigm shift in the mainstream acceptance of methods and products promising to help us stay ahead of the clock. Younger people even in their teens and 20’s are countering the aging process beginning with sunscreen and smart skincare. As men and women get into their 30s they see the signs of aging take place. Botox has become a preventative medicine against wrinkles, offering a cumulative effect in minimizing lines of expression. They are a bit harder to treat if we wait until we are 50 trying to temper lines created over five decades. Small doses of fillers can make a difference in 30-somethings. But by 40’s and 50’s obvious changes are happening despite our best efforts. Volume loss and volume descent can be camouflaged non-surgically, but they cannot be reversed. Rebuilding and restoring collagen in the face is important, so chemical peels and laser treatments are popular at this stage. Once skin begins to noticeably sag, it is time to consider a facelift and possible fat grafting for the most natural outcome.

Skincare, injectables, surgery–when each are appropriate

Good skin is the hallmark of beauty regardless of age. Everyone should practice good skincare because no amount of filler or surgery can improve skin’s quality. The sun is skin’s biggest enemy. Once the damage is done, lasers and chemical peels can help improve the texture and tone for a more youthful appearance. Fillers fight volume loss by plumping up areas where fat has shifted or atrophied. A facelift will lift sagging cheeks and jowls by re-draping the skin over repositioned layers of muscle. Keep in mind that skincare, fillers and surgery work in concert. One cannot substitute for another, yet when used together, properly, there is tremendous synergy. Skincare cannot address volume any more than fillers can correct banding in the neck. Using more and more fillers thinking you are postponing surgery often leads to a distorted, obvious look. It’s important to respect the boundaries and distinct benefits of each of these modalities.

“Mini” facelifts

A big misconception is that there is much less recovery and smaller scars with a mini facelift. In fact, any facelift that is going to provide substantial results requires similar incisions and downtime. Lifts that only tighten the skin or only use small incisions often lead to short term results with inadequate skin removal. In these cases, “mini” facelifts often lead to “mini” results. Likewise, the “lunchtime” procedures that are advertised as delivering astonishing results are poor simulations of a facelift. There are no short cuts. Would you fix just a part of the foundation of your house? No, because it would give you an incomplete outcome. It’s the same logic with your face.

The truth about “noninvasive, no scarring, no downtime, no discomfort” procedures is that often you are not getting value for your money. It’s important to recognize that there are no miracles and magic wands. No one should expect dramatic results without respecting the process it takes to make a real, long lasting change in appearance.

Why obvious, overdone results are on display everywhere–even amongst celebrities

The rich and famous are just as capable of making bad decisions as the rest of us. In Hollywood particularly there are lots of non-certified surgeons doing cosmetic surgery. It’s a hotbed for unsubstantiated marketing hype. Celebrities are constantly in the public eye so it is easy to identify when a dramatic change happens–for better or worse. But remember–all we see are the bad results–and unfortunate outcomes don’t discriminate. For every Meg Ryan, Melanie Griffith and Priscilla Presley, there are lots of average people that keep programs like “Botched” alive. The point is, do your homework. Another way to look at this is how many patients are out there who have had brilliant “work done”? They look great for their age, but you can’t quite figure out what they did. That is the signature of a great surgeon–whether the procedure was surgical or non-surgical.

Quite frequently the cause of some looking distorted is over use of filler products. This happens in cases where the patient is not consulting with a plastic surgeon. If all the practitioner uses is filler, they may compensate for what they don’t have by just using more filler. Then, the patient looks odd and different instead of better. One of the biggest benefits to seeing a Board Certified Plastic Surgeon–whether you need surgery or not, is to get the proper diagnoses from someone who has all the tools at his disposal.


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Contact our office to schedule a private consultation with Board Certified Plastic Surgeon, Dr. Michael Lee. This is the next step to determine which Park Cities Cosmetic Surgery procedure is the best option, giving you the desired outcome after surgery. Dr. Michael Lee will spend time with you to learn about your medical history and your expected outcome for surgery, as well as explaining the procedure in detail and answering all of your questions.

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