[DuHan Plastic Surgery Facial Autologous Fat Grafting] - [Microfat Grafting for the Under-Eye Aegyo-Sal Procedure]

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For the under-eye aegyo-sal procedure

Microfat Grafting

When the under-eye area is hollow or has indented wrinkle lines,

and dark circles make the eyes look less attractive,

this procedure is performed to improve those concerns.

Fat is harvested with a thin suction cannula from the lower abdomen or thighs,

then grafted under the eyes using a microfat grafting cannula,

to correct under-eye hollows and wrinkle lines

and brighten the skin tone.

The relationship between dark circles and aegyo-sal

When dark circles are distributed directly beneath the eyelashes, fat can be grafted to create a raised aegyo-sal line in this area. During this process, the dark skin is expanded and the yellow fat fills in, which helps reduce the appearance of dark circles.

In addition, aegyo-sal is created, changing the eyes into a more attractive shape.

However, if aegyo-sal is created in eyes with an under-eye hollow, the shadow effect below the aegyo-sal becomes more pronounced and the under-eye area looks darker. For that reason, aegyo-sal should only be performed after an accurate examination and only for suitable candidates.

Fat grafting procedure method for an attractive eye shape

1. Fat is harvested from areas where body fat is more abundant, such as the lower abdomen, waist, or thighs. - Because local anesthesia (painless sleep anesthesia) is used, there is no pain at all. - A thin liposuction cannula is used to collect the fat into a syringe.
2. The harvested fat is centrifuged to remove impurities (anesthetic, oil, blood, etc.).
3. Oil is removed through a two-step purification process. Only when almost all the oil is removed can it truly be called concentrated fat.
4. The purified fat is placed into a 1 cc syringe. Usually, about half to one 1 cc syringe is grafted to one under-eye area.
5. A microfat grafting cannula is inserted along the planned design line under the eye to perform the grafting. We use Micro Needle, a microinjection cannula developed in-house. Micro Needle is a special grafting cannula used only at our clinic for ultra-precise grafting. The graft is placed within or above the orbicularis oculi muscle layer, creating soft contours and a high graft survival rate.
6. After grafting, you can return to daily life immediately, and washing your face and wearing makeup are possible starting the day after the procedure.

Under-eye microfat grafting should basically be performed as a three-dimensional fat graft.

After fat grafting, the appropriate amount must be spread evenly to prevent a bumpy contour.

Usually, the graft is divided and placed below the orbicularis oculi muscle, within the orbicularis oculi muscle, and above the orbicularis oculi muscle.

For this, subcutaneous tunneling is inevitably performed, and bruising occurs at this stage.

The area around the eyes has many blood vessels, so some bruising is unavoidable.

If tunneling is not performed and the graft is inserted directly in order to minimize bruising, bruising may be reduced, but in most cases the shape becomes awkward or bumpy. Therefore, good results can only be achieved when thorough pre-grafting preparation through subcutaneous tunneling is performed.

http://www.microfat.net

Examples of aegyo-sal microfat grafting procedures

Aftercare following the aegyo-sal procedure

"Aegyo-sal is an area where bruising often occurs during under-eye fat grafting, so careful bruise management is necessary."

◇ From the day after the procedure, cover the bruised area well with skin-colored makeup.

◇ Daily life is possible starting the day after the procedure, and if swelling does not subside well after about a week, it is good to receive an injection to reduce swelling.

◇ After 4 days, it is fine to sweat in a sauna or jjimjilbang.

Other methods for creating aegyo-sal

◆ Filler products (Restylane, Juvederm, Aquamid, Artecoll)

There are many different types of commercial filler products.

They were generally developed to improve fine wrinkles, so there is no particular problem if they are used for that purpose.

However, they are not suitable for use in large amounts.

Also, some products can easily cause inflammation and may even lead to serious side effects.

Because most filler products are colorless and transparent, when used to create aegyo-sal, the under-eye area becomes bulging and turns almost translucent, like a blister, which often looks awkward when contrasted with the surrounding skin color.

They are not recommended because of the risk of side effects and the unnatural appearance caused by color mismatch when creating under-eye contours.

◆ Method using fat repositioning

Some clinics may suggest creating aegyo-sal through fat repositioning.

It is not possible to create a satisfying aegyo-sal with fat repositioning.

Aegyo-sal should protrude gently right below the eyelashes, but orbital fat cannot be forced toward the lash line to create a natural aegyo-sal contour.

In most cases, the shape of the aegyo-sal is barely formed, or the bulge appears not directly under the eyelashes but below that area, making the shape look awkward.

Caution is needed when creating aegyo-sal with fat repositioning.

◆ Method using Alloderm (artificial dermis)

Some people create aegyo-sal using solid artificial dermis such as Alloderm or Surederm, but this requires incision of the skin, carries the burden of scar formation, and can result in an unnatural appearance rather than a natural shape, so it is not a recommended method.

In the case of liquid Alloderm, the cost is high and the absorption rate is high, so when a sufficient protrusion is desired, the result is often unsatisfactory.

Frequently asked questions and answers about the aegyo-sal procedure

If aegyo-sal was created with filler, can it be corrected with fat grafting later?

People who have had filler treatment often want fat grafting again because of various problems.

However, once a person has received filler treatment, aegyo-sal fat grafting cannot be performed.

The reason is that the filler-treated area does not provide the conditions needed for fat to survive and integrate.

Because blood circulation is poor, the fat cannot survive, and side effects such as inflammation or fat necrosis may occur. Even if the fat survives, the survival rate may be low or the shape may not look natural.

Some people ask whether the filler can be completely dissolved with a dissolving injection and then fat grafting performed. If the treatment was done with a hyaluronic acid filler (such as Restylane or Juvederm), it can be dissolved with an enzyme injection called hyaluronidase.

However, unless the filler is almost completely dissolved with the dissolving injection, fat grafting is not possible if any part remains and the aegyo-sal shape is still there.

Even if the filler is dissolved with a dissolving injection, some of it remains, so there is still concern about inflammation after fat grafting. In principle, anyone who has ever used filler cannot undergo fat grafting.

I had lower eyelid surgery because of under-eye wrinkles. Is aegyo-sal fat grafting possible?

Lower eyelid surgery is a method of removing skin and tightening it to smooth wrinkles caused by under-eye wrinkles or sagging.

After lower eyelid surgery, the skin is pulled taut, so there is no excess skin, and scar tissue forms directly below the eyelashes.

In this condition, creating aegyo-sal is difficult.

For aegyo-sal to form naturally, there must be some skin looseness so it can expand, but after lower eyelid surgery, the skin has been excised, leaving almost no room for expansion.

Also, the scar tissue at the incision line makes it difficult to create the proper shape.

Therefore, after lower eyelid surgery, it is difficult to create aegyo-sal.

As an exception, if the scar line is faint and it has been a long time since the lower eyelid surgery, and there is at least a little excess skin, it may be possible to create a small amount of aegyo-sal.

If aegyo-sal was created with Alloderm, can it be corrected with fat grafting later?

People who have undergone treatment with Alloderm (artificial dermis) often want fat grafting again because they are dissatisfied with the shape.

Since Alloderm is living tissue, fat grafting can be used to shape it as long as the Alloderm has not protruded in a very awkward way.

However, if the shape is awkward, the protrusion is severe, or the protrusion is not directly below the eyelashes but instead occurs below that area, then correction with fat grafting is difficult.

Conversely, fat grafting is possible only when the Alloderm has been placed in the proper position directly below the eyelashes and the shape is only mildly pronounced.

At other clinics, they say that if aegyo-sal is created with fat grafting, the shape will not look pretty and irregularities will form. Is that true?

There are clinics that perform contouring carelessly using filler.

Our clinic also uses filler, but only for fine wrinkles or small depressed scars.

Fillers such as Aquamid, Restylane, and Artecoll were not made for contouring surgery.

Therefore, their use involves difficulties, and there are various problems such as side effects and reduced treatment effectiveness.

The issue is that some doctors who are not specialists in plastic surgery, and some with limited experience, overuse filler treatments.

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