Dr. Paris specializes in micro and macro fat grafting cannulas on the face. The diameter of the injection cannulas range from 3mm to 1mm depending on the area being grafted.

Volumes of replacement range between 5cc to 30cc of fat injected in a single session! Dr. Paris provides you a comprehensive facial analysis which will determine precise location and volumes of fat grafting which include:

Your results following fat grafting are dependent on several factors. First, the fat material needs to be handled gently as the fat cells are fragile and vulnerable to damage. The fat is gently handled from the extraction phase, to the processing phase, and then to the transfer phase. Dr. Paris avoids all pressure exposure to the fat cells which has been associated with fat cell death. As a result, he avoids centrifugation of fat cells; instead, he utilizes only gravitational purification of cells. More importantly, he minimizes the processing and transfer duration (this is the time during which the fat cells spend outside the body). Think of fat cells as fish that are pulled out of water and start suffocating! Dr. Paris completes transfer of the fat cells within a few minutes of extraction from your body to minimize fat cell suffocation. Finally, Dr. Paris uses micro fat transfer technique placing each fat particle in 0.1cc aliquots. This process is very meticulous but it maximizes the surface area to volume of fat cells transferred, further ensuring delivery of nutrients back to the fat cells that have been temporarily displaced from their home. The above measures are critical in obtaining effective and natural results.

A fat grafting procedure transfers fat from areas in which you have excess fat, such as under the neck, and injects it into areas that may be lacking in volume, such as your cheeks, lips, etc. Today, fat cannot be transferred from one person to another i.e. you can only transplant from yourself, thus termed auto-transplanation. This safe, long-lasting, well-tolerated procedure produces natural-looking results. Every year, thousands of people undergo successful fat grafting and are pleased with the results.

• If you have facial areas that appear creased and sunken
• If you desire more permanent correction than is provided by temporary fillers
• If you desire larger volume replacement (10 to 30cc) in the face that is not amenable to treatment with conventional fillers (1cc per syringe)

Many people who consider fat transfer also consider liposuction of the neck, botulinum toxin injections, and even face and neck lifts.

Fat is harvested from one part of your body, washed and purified, and then carefully reinjected with specially designed needles into the areas that need augmentation. It may be necessary to repeat the fat grafting procedure several times to achieve the desired result. Fat grafting can be explained as a three-stage process: (1) harvesting (2) purification and transfer and (3) placement.

Harvesting: You and your surgeon will select a site for fat removal and will inject it with a local anesthetic. Your surgeon will then create a small incision in the area for fat removal and, using a sterile technique, insert a cannula connected to a syringe to carefully extract fat (liposuction).

Purification and transfer: Once enough fat is obtained from the donor area, your surgeon will process it to prepare the fat cells for transfer to small syringes that will be used for fat injection. Purification for facial grafting is done on Telfa pads which carefully absorb the undesired liquid part of the fat.

Placement: The area designated to receive the graft will then be prepared. Your surgeon will insert a needle or cannula into the incision point of the site being augmented. The injection needle is usually passed in and out of the areas to be augmented multiple times. Each time the needle or cannula is withdrawn, small aliquots(0.1cc) of fatty tissue parcels are carefully deposited into natural tissue planes. This process is repeated until the desired correction has been achieved, creating a grid of grafted fat.

The goal of your aesthetic plastic surgeon and the entire staff is to help you achieve the most beautiful and natural-looking results, as well as to make your surgical experience as easy and comfortable as possible.

• Because liposuction incisions are small, the healed incision lines are also small and are placed in hidden areas.
• The amount or degree of scarring depends on the surgeon’s technique and your genetic tendencies.
• Most liposuction scars fade and are barely perceptible over time.
• Grafting sites over your face and lips are only 2mm in length and virtually heal without any scarring at al.

Several areas can now be successfully filled by fat grafting including the cheeks, jawline, laugh lines extending from the corner of the lip (those extending up are called nasolabial folds; those extending downward are called marionette lines), in the hollow of the lower eyelids, temple region, under the eyebrows, under the upper eyelid(if fat was over-resection following upper eyelid surgery), and the lips.

Why is 30% of the fat transferred volume lost at one year follow up?

Fat grafting requires avulsion of fat cells from their residence where they maintain a vascular supply to a new environment where they possess no direct vascular supply. As a result fat cells are required to keep alive by obtaining their nutrients by virtue of diffusion until a direct vascular supply sprouts into them. During this delay prior to vascular supply reintroduction it is believed that approximately 30% of cells do not make it and are eventually reabsorbed by the body over a one year period. In order to optimize fat cell viability, fat cells are transferred in 0.1 to 0.2 ml micropackets so that their surface area to volume ratios are maximized. This allows more of the cells to live by diffusion until the vascular supply is re-established.

Fat grafting of the face requires modified micro-cannulas to liposuction fat cells followed by processing of the fat cells, and finally re-injection of fat cells into volume deficient areas. Both harvesting of fat and injection of fat utilize micro-cannulas which are smaller version of cannulas used in breast and body fat grafting. As a result postoperative pain associated with fat grafting of the face is negligible. Patients should expect to be sore for just a few days. Patients often avoid taking any pain reducing medications.

Fat grafting has become a mainstay of the plastic surgeon’s armamentarium and allows previously untreatable deformities to be corrected.

Patients benefiting from fat grafting techniques include:

• Patients who have developed breast deformities following failed implant augmentation.
• Patients who have developed contour irregularities following liposuction surgery.
• Patients desiring minimal to moderate degrees of buttocks augmentation.
• Patients who have developed traumatic scarring related divot or hollow deformities.
• Breast reconstruction patients.

All of the above Fat Grafting patients benefit from the ability of fat cells to be used, much like putty, to correct large soft tissue deficits as well as subtle contour irregularities.