Site Map — Facial Cosmetic Surgery in Los Angeles, California — The Practice of Dr. Michael Schwartz

Lipotransfer

Lipotransfer, or fat transfer, is a procedure that involves transferring fat from one area of the body (usually the abdomen) to another. The fat is placed in small beadlike amounts throughout areas of the body or face that have lost fullness. The aging process can cause facial fullness and volume to diminish. Because fullness of the face is a sign of youthfulness, I avoid suctioning fat from the face, and I frequently transfer fat to the face to achieve a more youthful look. This can be done alone or in combination with a facelift. In the facelift procedure, deeper compartments of fat and muscle are repositioned; the laxity of the face and neck are tightened; and fat is used in the brow area, midface, and lower face to restore fullness where it is lacking. When performed alone, fat transfer can correct areas of atrophy due to aging, illness, or medication. Most commonly it is placed in the nasolabial folds, the cheeks, and the lower corners of the mouth, or “marionette lines.”

Degree of Permanence

There is much discussion about the permanence of fat grafting. When fat is transferred from the abdomen to the face, it becomes a free graft. A free graft is similar to a skin graft; however, because the free graft is hidden from view, assessing its degree of permanence is more difficult. The transferred fat must develop a blood supply before it becomes viable tissue in its new home.

If large cylinders (or clumps) of fat are transferred, blood vessels may not reach the core and most, if not all, of the fat will dissolve. There is a significant risk of lumpiness in any fat that remains. Therefore, I use a technique in which fat is carefully harvested on a lower suction setting so as not to lyse, or destroy, the fat cells. The fat is separated in one step from fluids such as the anesthetic solution, and it is transferred to small, 1cc syringes. Then the fat is injected into the desired area in multiple layers and directions, achieving a very precise sculpting effect.

Utilizing this technique, I can say that most patients have a large degree of permanence in the areas treated. However, factors such as each patient’s skin type, healing abilities, and other variables contribute to the degree of permanence. Because of these variables I cannot guarantee any degree of permanence. We inform patients that usually one treatment is effective. When touch-up procedures are performed one or two years after the original procedure, the fee is 50 percent of the first procedure.