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Facial contouring

Cheek Volume, Forehead, Temporal Area

Fat Grafting

Cheek fat grafting is

used in cases where the area below the cheekbones is sunken, making the face look tired,

or making the person look older.

Aesthetically, it restores the face to an oval shape

and also provides a youthful-looking cosmetic effect.

The foundation of facial fat grafting is cheek fat grafting,

and it is the area where the image-improvement effect is greatest.

If there is hollowing or curvature in areas above the cheekbones, such as the temples or forehead,

fat grafting can also naturally and beautifully

correct the contour.

Areas of the face where fat grafting can be applied

○ Sunken areas of the forehead or forehead wrinkles ○ Temporal hollowing in the temples ○ Sunken cheeks below the cheekbones ○ Gaunt facial cheeks ○ Faces with facial asymmetry ○ Cases where the facial contour looks too flat or sunken

Fat grafting procedure for facial contour correction

1. Fat is harvested from areas where your own fat is abundant, such as the lower abdomen, waist, or thighs.

• Because the anesthesia is local anesthesia (painless sedation anesthesia), there is no pain at all.

• A thin liposuction cannula is used to collect fat into a syringe.

2. The harvested fat is placed in a centrifuge to obtain pure concentrated fat.

The purpose of centrifugation is to remove unnecessary components, reduce side effects of fat grafting, and increase fat survival rates.

3. After centrifugation, the fat goes through a second concentration process to remove water and oil.

By removing water and oil, nearly 100% concentrated fat is obtained.

The fat is measured into 1 cc syringes as needed.

For facial contour correction, fat grafting usually requires about 10 to 20 cc of concentrated fat.

4. The fat is grafted into the area where local anesthesia has been applied.

For fat grafting, the fat is placed after tunneling is completed and space for the grafted fat has been secured.

Our clinic uses the Micro Needle (micro grafting cannula), developed in-house.

The Micro Needle is a special cannula used only at our clinic that allows ultra-precise grafting.

The principle of fat grafting is to distribute the fat evenly over the grafted area so that it does not clump, while maximizing survival rates as much as possible.

Effects of the fat grafting tunneling technique

Rather than injecting a large amount into one place, the tunneling technique performs 3D micro fat grafting with 100% concentrated fat, evenly and uniformly across multiple layers.

Using a delicate and meticulous injection method, custom design is possible.

Fat grafting also includes a process called “tunneling,” which allows the grafted fat to remain in contact with abundant surrounding blood vessels as much as possible so that it can continuously receive nutrients.

Tunneling means using a micro needle just beneath the skin to create space for the fat. Because space is created like drilling a tunnel and then the fat is injected afterward, even after all of the fat has been placed, it does not sag in the direction of gravity or become uneven.

Because the tunneling technique includes a dissection process for wrinkles, fat is grafted beneath the dissected wrinkles, so wrinkles improve more clearly compared with fat grafting at other clinics.

Examples of fat grafting procedures

1. Forehead hollowing

For the forehead, this is performed in cases with hollow areas or a flat forehead.

Silicone or Alloderm implants can also be inserted, but there is the fear of having to make an incision in the scalp, and there are burdens and issues such as side effects from inserting foreign materials. Fat grafting can simply correct the forehead contour while solving these problems.

2. Temporal area (temple) hollowing

In cases where temporal hollowing makes the cheekbones look more prominent or the face look longer, fat grafting can replace the method of inserting silicone, and the sunken area can be naturally raised to create a soft facial contour.

3. Gaunt cheeks

① Severely gaunt and wrinkled face

If the face looks gaunt, it appears older and also gives a tired impression, so it is better for the cheeks to have some volume.

There is no other method besides fat grafting to add volume to the cheeks.

Commercial fillers such as collagen or Restylane cannot compare with fat grafting in terms of cost or effectiveness.

② Narrow inverted-triangle face

If the face shape is an inverted triangle, fat grafting can make the face look fuller and more balanced.

In such cases, fat is grafted from below the cheekbones to the jawline to create volume.

With fat grafting, the frontal face shape can change into a fuller-looking face.

③ Cases where the cheekbones appear prominent

If the cheeks are thin or the sides of the face are sunken, the cheekbones can look relatively more prominent.

Before considering cheekbone reduction surgery to push the cheekbones inward because they look prominent, you can first think about cheek fat grafting below the cheekbones so that the cheekbones appear relatively less prominent.

If cheek fat grafting provides enough corrective effect for the cheekbones, there may be no need to undergo difficult cheekbone surgery.

④ In cases of square jaw

Even when the jaw angle is large and the face is square-jawed, correction can be achieved with fat grafting.

By grafting fat into the sunken areas above the square jaw, a visual corrective effect can be achieved without jawbone surgery.

As the cheeks gain volume, the square-jaw area appears relatively less prominent.

If you are considering jawbone surgery for a square jaw, it is good to first consider cheek fat grafting.

If cheek fat grafting provides enough corrective effect for the square jaw, there may be no need to undergo difficult jawbone surgery.

⑤ Side cheek hollow lines

If the sides of the face are sunken and look like a furrow in a field, the sunken area can be naturally filled to create a softer contour.

The sides of the cheeks are tightly attached to the bone and tissue, making it a very difficult area in which to create natural volume.

The part of cheek fat grafting that requires the most difficult technique and expertise is filling in the lateral hollow lines.

⑥ In cases of facial asymmetry

Good results can also be obtained with fat grafting in cases of facial asymmetry caused by sunken areas on one side of the face or abnormal development of the jawbone or cheekbones.

Fat grafting can be performed only on the sunken side, or with different amounts on both sides, to help correct the facial asymmetry.

⑦ Men’s gaunt cheeks

Men, too, can look older or give too strong an impression if the face is angular or sunken.

For men, having a softer impression is better than a harsh, strong impression.

Cheek fat grafting is one of the most effective procedures for changing to a softer impression.

⑧ Cases where curvature occurs after fat grafting at another clinic

People often tend to think of fat grafting as something simple, but it is by no means a simple or easy procedure.

Some people think that fat grafting will produce good results anywhere, but fat grafting is more demanding than any other plastic surgery procedure, and it requires extensive experience, know-how, and very precise manual skill along with a very complex process.

There are many clinics that perform fat grafting, but not many that do it properly.

Fat grafting is easy to do, but difficult to make into proper results.

If you undergo the procedure at a clinic that merely imitates it without proper technique, it is easy to end up disappointed.

In principle, fat grafting can only produce good results when it is performed accurately.

It is better not to receive the procedure from someone who lacks experience or from a non-specialist who does not have board certification in plastic surgery.

⑧ Cases where the cheeks become bulging due to overinjection after fat grafting at another clinic

After fat grafting, the cheeks may look saggy or bulging because of overinjection or excessive graft survival.

In such cases, the shape is corrected by suction using a micro cannula.

As a rule, the timing of suction should be decided after waiting 3 months for the results to appear.

However, if the overinjection is excessive and the shape looks too unnatural, suction may need to be done earlier.

What are the advantages of facial contour correction with fat grafting?

1. The procedure is simple.

2. Because foreign materials are not used like fillers (Restylane, Radiesse, Artecoll), there is no concern about side effects.

3. Since the procedure is performed without incisions to the skin, there is no concern about scars.

4. Because it uses autologous tissue, the shape looks natural.

5. There is almost no swelling or bruising.

6. You can return to daily life immediately after the procedure.

7. Because the fat tissue survives and integrates, the effect can be maintained for a long time.

What should you be careful about when correcting facial contours with fat grafting?

1. Fat grafting requires skilled technique and experience.

The results vary greatly depending on the operator’s skill, so poorly performed fat grafting can actually make the impression worse.

2. After facial fat grafting, no bandages or taping are applied.

Other than swelling and minor bruising, makeup is possible and normal activities can be resumed immediately, but for about 1 to 2 weeks the swelling may make things look a little awkward.

3. After fat grafting, running should be avoided for about one month, and alcohol and smoking should be avoided for about one week.

Except in cases where fat was harvested from the legs, walking, weight training, and stretching can be resumed after one week.

4. After cheek fat grafting, the fat survives over the course of 3 months, so it helps fat survival not to rub or press the cheeks strongly while it is taking hold.

Number of fat grafting procedures

Cheek fat grafting has a good survival rate, so in most cases one procedure is enough to achieve a satisfactory effect, and in some cases a second procedure is performed.

The interval between procedures is usually 3 months to as long as within 10 months, and it can be done using the remaining frozen fat.

For a repeat procedure, the fat collected during the first fat grafting can be thawed and used.

However, if 10 months have passed and a second procedure is performed, fat must be harvested again.

Long-term effects of fat grafting

Some people say fat grafting has no effect because much of it is absorbed, but this applies to cases where the fat grafting was poorly done.

Fat grafting can produce good results only when performed based on skilled technique and experience.

If fat grafting is performed correctly, a satisfactory effect can be achieved, and once the grafted fat survives, it is no longer absorbed and remains your own fat tissue for life, making it one of the safest and most effective methods.

On average, if you receive fat grafting once, or rarely twice, you can obtain a permanent and satisfying facial contour correction effect.

Side effects of fat grafting

Because fat grafting uses your own fat, it is correct that no side effects occur from the procedure itself.

However, unsatisfactory results or side effects may occur due to the operator’s inexperience.

The entire process, from fat harvesting to purification and grafting, must be carried out very delicately, carefully, and according to principles in order to achieve good results.

Poorly performed fat grafting leads to unsatisfactory results, so it is better not to undergo the procedure from a non-specialist with limited experience or without board certification in plastic surgery.

Duhan Plastic Surgery

Autologous Fat Grafting Clinic

Features and Advantages

http://www.duhans.com

All anesthesia is performed as local anesthesia (sedation anesthesia).

Local anesthesia is performed together with sedation anesthesia, and the procedure is carried out with absolutely no pain during anesthesia or after anesthesia is finished.

We have a systematic and advanced fat grafting system.

To harvest living fat cells and increase purity, we maximize purity through centrifuge purification and removal of unnecessary oil.

Before grafting, subcutaneous tunneling in the graft site secures space for the fat to be placed.

We perform precise grafting using a micro fat grafting cannula.

By grafting evenly across multiple layers in a 3D manner, we maximize survival rates and create soft contours.

We select appropriate and various fat-harvesting sites for collection.

The most commonly used site is the lower abdomen, which is often chosen as the first option because it has less post-procedure pain, less swelling and bruising, and is convenient for daily life.

After the lower abdomen, the inner thighs are selected, followed by the outer thighs.

If there is not enough fat to harvest from the thighs, the lower buttocks or flanks may also be used.

There is no fixed rule as to which area gives the best fat survival rate.

The results are similar, and while the ideal harvest site is the area with the most fat, it is better to decide the donor site by considering how much fat needs to be harvested and the activities after grafting.

We maximize fat survival through a two-step purification process for the harvested fat.

The impurity found in the highest proportion in harvested fat is local anesthetic, followed by oil.

Other impurities such as serum and red blood cells are also included.

In the first step, the fat undergoes centrifugation for about 3 to 4 minutes before entering the second oil-removal process.

Oil is removed manually through a natural absorption method.

Through the second purification process, nearly 100% concentrated fat is obtained, maximizing the effect of fat grafting and increasing fat survival as much as possible.

We secure space for fat grafting through subcutaneous tunneling.

Subcutaneous tunneling is the process of securing space in advance for the area where fat will be grafted, and it is an essential and important step for high fat survival and even grafting.

Using a thin probe, the under-skin area is moved repeatedly several times in a fan-like pattern to create space for the fat to be grafted.

The effect of subcutaneous tunneling is to increase fat survival and prevent clumping, so that a uniform and soft contour can be created.

3D micro fat grafting creates soft and even facial contours.

Although there are exceptions depending on the area, the basic method of fat grafting is the 3D technique.

The fat is divided into multiple layers and small amounts are evenly grafted into each area.

We use a micro fat grafting cannula for precise fat grafting.

In the past, methods using fat injection machines pushed fat under the skin at high pressure, which caused various problems.

The absorption rate of fat was high, survival was inconsistent, contours became uneven, and it was difficult to graft into delicate areas such as under the eyes.

To solve these problems, during fat grafting the fat is transferred again into a thin 1 cc syringe and grafted into the desired area.

We use the Micro Needle (micro grafting cannula), developed in-house.

The Micro Needle is a special cannula used only at our clinic that allows ultra-precise grafting.

Fat grafting can also be performed on the upper eyelids, lower eyelids, forehead wrinkles, glabellar wrinkles, nasolabial folds, and the bridge of the nose, making fat grafting possible in almost all cases except very fine wrinkles.

Immediately after fat grafting, molding is performed to create a uniform and soft facial contour.

Right after fat grafting, delicate molding is performed so that the grafted fat spreads evenly and a soft shape is created.

Molding is one of the final steps of fat grafting and one of the most important.

Rapid freezing and sterile storage of remaining fat simplifies a second procedure.

If a second procedure is performed after 3 months following fat grafting, the remaining fat from the first procedure is used without harvesting fat again.

The remaining fat after the first procedure is rapidly frozen and stored under sterile conditions.

During the second procedure, the stored fat is thawed, making the treatment more convenient.

The storage period for fat is up to 10 months, and if you visit within 10 months, the procedure will be performed using the stored fat.

At Duhan Plastic Surgery’s Autologous Fat Grafting Clinic, based on more than 20 years of rich clinical experience and know-how, we perform multilayer (layer-by-layer) fat grafting.

The key to fat grafting is ensuring that living fat cells have a high survival rate.

To increase fat survival, we do not inject a large amount into one place, but instead graft evenly and uniformly across multiple layers.

Between the skin and bone there are many tissue layers such as fat and muscle, so the fat must be injected in a multilayer structure—between the periosteum above the bone, or above and below the muscle fascia—without overlap.

Multilayer fat grafting lasts 3 to 4 times longer than conventional methods, and fat survival is also higher.

Fat grafting at Duhan Plastic Surgery’s Autologous Fat Grafting Clinic also includes a process called “tunneling,” which allows the grafted fat to remain in contact with abundant surrounding blood vessels as much as possible so that it can continuously receive nutrients.

Tunneling means using a micro needle just beneath the skin to create space for the fat. In other words, space is created like drilling a tunnel and then the fat is injected afterward, so even after all of the fat has been placed, it does not sag in the direction of gravity or become uneven.

In addition, delicate injection methods allow for custom design.

Through thorough aftercare after fat grafting, we carefully monitor the progress until the fat has fully taken hold.

During follow-up, if necessary, we try to minimize dissatisfaction through swelling-reduction injections, shape correction, and molding.

http://www.microfat.net