Knife Vs Needle

By: Beth Phillips, RPAC

Until this past decade, traditional surgical facelifts were the mainstay for rejuvenation of the face. These were considered big procedures that were mostly reserved for the rich and famous. Over the past several years, however, plastic surgeons have realized that one of the major factors which makes people’s faces look older is a loss of volume.

Because of this, simply re-positioning and lifting the skin of the face is not always enough to provide a youthful result. This has led to the development of many options to improve the appearance of the aging face which do not involve surgery but rather volumizing the face. Although many times used in conjunction with traditional facelifts, these procedures alone can provide a very significant improvement without “going under the knife.” under the knife”.

As we age, our faces undergo changes in both skin and soft tissue. Historically, it was thought that the skin just got saggy, and this caused the look of aging. Although there is some loosening of the skin over time, a major factor which makes people’s faces look older is the loss of volume. If you look at the pictures of a person in their 20s, their face will look fuller and rounder, even if they weighed less at 20 than they do at 50. As we age, the location of our fatty deposits tends to shift away from our faces and into less desirable areas.

As plastic surgeons became more aware of this, the trend over the last several years has been to not only to reposition facial tissue but to add volume. Although frequently combined with traditional face lifting, this technology has become a procedure unto itself, which alone can provide excellent results.

Traditional facelifts require incisions that extend from the hairline along the front of the ear and travel to the back of the ear and back into the hairline. Although these incisions usually heal very well, many patients do not have the interest, time or desire for such an involved procedure.

An exciting new option for patients is simply adding volume to the face which can reverse many of the changes associated with facial aging. These procedures tend to take much less time and have a shorter recovery than standard traditional facelifts. This allows patients to return to work and social functions much more quickly and also allow for a somewhat more gentle and gradual improvement.

Options to increase volume include synthetic fillers, as well as the patient’s own fat. Fillers are temporary gels that are injected into the face to achieve fullness. These last anywhere between six months and two years, depending on the product injected. There are a number of different fillers, each formulated for a specific function and area of injection. For example, thicker and more dense fillers tend to be used for deeper filling such as cheeks, while very superficial area such as lips and lower eyelids use a less dense filler. These products provide immediate and reproducible results.

An option which is gaining more popularity recently has been the use of the patients own fat to provide facial volume. Although using fat to add volume has been used for many years, it is becoming much more mainstream as a facial filler. The advantage to fat is that it is utilizing the patients on tissue, there is a reasonably large supply available, and most importantly the results can be permanent. Unlike synthetic fillers, once fat is injected and has “taken” (meaning that the blood supply is reestablished) the fat that is transplanted remains permanently. This allows for significant addition of volume which does not need to be repeated.

The fat grafting procedure is more involved than utilizing synthetic fillers. Fat must be harvested from another part of the body, usually the abdomen, and then processed to prepare it for injection. Once this is done, the fat is then re-injected into the face using very small needles called cannulas to add volume and correct wrinkles. Unlike fillers, all the fat injected does not remain. A certain portion of the fat will be absorbed, which means that more fat than the final amount needed has to be injected. The healing process is sometimes longer than with synthetic fillers, as there can be some associated bruising and swelling. That being said, once the swelling settles down, the results tend to be extremely natural and long-lasting. As a bonus, the fat cells contain growth factors and stem cells, which have the added benefit of improving skin texture and quality.

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