[Duhan Plastic Surgery Face Autologous Fat Grafting] - [Noble Surgery and Indian Band Fat Grafting]

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What is fat grafting

Fat grafting is also called fat injection.

Because it involves delicate and precise fat grafting,

it is also called micro fat grafting.

It uses a syringe to harvest your own fat and then uses a syringe again

to inject it into the desired area to correct the facial contour.

The key to micro fat grafting is

natural and soft contour expression and a high survival rate.

Using three-dimensional volumetric fat grafting and two-dimensional planar fat grafting,

the most ideal fat grafting is performed for each area.

Except for bone surgery such as zygoma and jaw surgery, contour correction of other sunken areas

can be performed with fat grafting.

The procedure is simple, has no side effects,

and can be naturally corrected as much as desired in any area,

so it is one of the best facial contour plastic surgeries.

Noble surgery

When the front part of the face is flat or sunken,

or when there are sunken wrinkles beside the nose, this refers to contour surgery that lifts and adds volume.

The effect of the procedure is

that the front part of the face appears more three-dimensional or fuller,

and the treatment area can refer narrowly to the sunken area of the nasolabial fold beside the nose,

or broadly to include the under-eye wrinkles, the front part of the cheek, and the entire nasolabial fold line.

Indian band - front zygoma wrinkles

These are the sunken wrinkle lines that run across the front zygoma area.

They are also called front zygoma wrinkles,

and the cause is mostly congenital,

and in some cases the wrinkle line is clear even at a young age.

If there is a wrinkle line, it makes you look older

and gives a bad impression, so the wrinkle line should be corrected.

Indications for noble surgery

△ When the front part of the face beside the nose lacks volume and appears flat

△ When the front part of the face beside the nose is sunken and appears hollow

△ When there are sunken wrinkle lines (nasolabial folds) beside the nose

Three area-specific treatment zones for noble surgery

△ When only the sunken wrinkle line beside the nose (nasolabial fold) is treated

△ When the under-eye area is sunken and the front part of the face beside the nose is sunken and flat, so the under-eye area and the front part of the face are treated

△ When the front part of the face beside the nose is sunken (including the under-eye sunken line) and there is a nasolabial fold line, so the front part of the face and the nasolabial fold line are treated at the same time

◆ Noble surgery is a colloquial term rather than an official plastic surgery term, and since it is difficult to strictly limit the treatment scope, the treatment area is applied more broadly and in more diverse ways.

As shown in the photos below, it is usually performed in three types.

◆ Depending on the sunken area, location, and region of the face, noble surgery is performed by precisely marking the treatment area using an appropriate design method.

Types of noble surgery

Method using an artificial implant

Correction can be performed by inserting a solid artificial implant such as Gore-Tex or silicone Medpor through an incision inside the mouth. In such cases, a surgery with an incision of about 2 cm inside the mouth is required, and there is a burden of having a foreign material inserted. In addition, unnatural appearance when smiling or a sense of foreign body may occur, so removal of the implant is also frequent.

Method using fat grafting

When correction is performed using fat grafting, the treatment area can be widened, and depending on the individual, it can be designed in various ways so that the desired shape can be applied to the desired area. It can be performed including the nasolabial fold line, the front part of the face, and even the under-eye area. There is no discomfort with a foreign substance, and natural contour expression is possible. In addition, because it is autologous tissue, there is no sense of foreign body or unnatural shape, and it is natural, and daily life can be resumed immediately.

How three-dimensional micro fat grafting is performed for noble surgery and Indian band treatment

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

• Since local anesthesia (painless sleep anesthesia) is used, there is no pain at all.

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

2. The harvested fat is placed in a centrifuge to remove impurities (local anesthetic, serum, red blood cells, etc.).

The purpose of centrifugation is to obtain pure, concentrated fat, reduce side effects after grafting, and increase fat survival.

3. The fat that has completed centrifugation undergoes a secondary concentration process to remove moisture and oil.

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

4. The purified fat is transferred into a fine 1 cc syringe and grafted into the desired area.

The fat is again transferred into a fine 1 cc syringe and grafted into the desired area.

The micro needle (micro graft cannula) developed in-house is used.

The micro needle is a special graft cannula used only here, enabling ultra-precise grafting.

When grafting, a subcutaneous tunneling procedure must be performed in advance before grafting so that the fat can be grafted accurately into the wrinkle area and effectively correct wrinkles.

5. After fat grafting, daily life is possible immediately, and washing the face and applying makeup are possible starting the next day.

Examples of three-dimensional micro fat grafting for noble surgery

Examples of three-dimensional micro fat grafting for Indian band treatment

http://www.microfat.net

We perform three-dimensional micro fat grafting using 100% concentrated fat.

To minimize swelling and bruising during the procedure,

a swelling-reducing agent is mixed with the anesthetic and administered together.

We use painless sleep anesthesia under local anesthesia.

There is no need to worry about pain.

Noble surgery is needed when the front part of the face is sunken or flat.

Noble surgery can also be performed using implants,

but based on more than 20 years of rich clinical experience and know-how,

our clinic performs noble surgery with micro fat grafting.

Implants have the drawback of limited treatment scope and a foreign-body sensation.

Micro fat grafting allows effective application over a wider range.

Director Shin Du-han

Advantages of noble surgery - three-dimensional micro fat grafting for Indian band treatment

① The procedure is simple, and daily life is possible immediately after the procedure. - No bandages or dressings are wrapped around the face.

② Because implants such as silicone or Gore-Tex are not used, there is no concern about a foreign-body sensation or side effects.

③ Because the procedure does not require an incision inside the mouth, normal daily eating is possible right away.

④ Because it uses autologous tissue, the shape is natural, and the procedure can be performed in a variety of shapes and ranges.

⑤ There is almost no swelling or bruising.

⑥ Once the fat tissue survives, the effect of the procedure can be maintained for a long time.

Number of sessions and intervals for noble surgery - three-dimensional micro fat grafting for Indian band treatment

For noble surgery and most fat grafting procedures, satisfactory results can be obtained with an average of 1 to as many as 2 sessions.

The interval between procedures is at least 3 months, and when performing a repeat procedure, the fat that had been stored from the first fat grafting can be thawed and used.

However, because results vary greatly by hospital, only accurate and principled procedures can achieve good results.

Duration of effect of noble surgery - three-dimensional micro fat grafting for Indian band treatment

Some people say fat grafting is ineffective because much of the fat is absorbed, but this applies when the procedure was performed at a clinic with somewhat insufficient experience.

In principle, if fat grafting is performed correctly, satisfactory results can be obtained, and once the grafted fat survives, it is no longer absorbed and remains as your own fat tissue for life, making it one of the safest and most effective methods.

On average, 1 to 2 fat grafting sessions can achieve a permanent and satisfying facial contour correction effect.

Precautions after noble treatment - Indian band treatment using autologous fat grafting

① Do not press hard or massage until the fat has survived.

② For about a month, do not smile excessively, as strong facial expressions can compress the grafted fat and lead to absorption.

③ Refrain from drinking alcohol and smoking for about one week to help the fat survive well.

Comparison between noble surgery - three-dimensional micro fat grafting for Indian band treatment and other methods

	Silicone, Medpor (implant)	Fat grafting
Whether an incision is made	Incision through the inside of the mouth or inside the nose	No incision is needed.
Procedure time	1 hour	30 minutes
Wrinkle improvement effect	Not effective for wrinkles around the mouth	Also effective for improving wrinkles around the mouth
Treatment scope	The scope is limited	Can be applied to a variety of wide areas
Return to daily life	Daily life is possible, but pain and swelling are severe, and when an incision is made inside the mouth, eating can be difficult	Daily life is possible, and swelling is mild

Side effects of fat grafting

Of course, good results should be obtained, but depending on the surgeon's skill and technique, unavoidable problems may sometimes occur.

Poor results due to a low survival rate, unnatural shape, asymmetry, severe swelling, inflammation, fat necrosis, calcification, unevenness, sagging, pigmentation, etc. may occur.

Inflammation	Occurs when bacteria invade during the procedure or when the fat does not survive and melts during the survival process
Necrosis	A state in which the fat that did not survive due to inadequate blood supply during the survival process has rotted and melted, leaving residual material
Calcification	A phenomenon in which fat that did not survive due to inadequate blood supply during the survival process hardens, calcium is deposited, and it becomes a hard lump
Unevenness	A phenomenon in which the shape does not come out evenly and becomes bumpy when fat is not grafted uniformly or is concentrated in only one area
Sagging	If too much is grafted or grafted in the wrong position, sagging of the face may occur
Pigmentation	When bruising and swelling are severe, depending on one’s constitution, iron components left in the bruise may deposit in the skin and oxidize, turning brown; this may sometimes occur after under-eye procedures depending on the constitution
Asymmetry	When the survival rate differs between left and right, or when the amount is not properly controlled during the initial procedure, causing left-right imbalance
High absorption rate	A phenomenon in which enough fat does not survive to produce the desired contour, and much of it is absorbed, so the appearance before and after the procedure does not change much
Unnatural shape	A phenomenon in which too much fat survives or is grafted to an inappropriate area, disrupting the overall balance of the face

Side effects of fat grafting

Because fat grafting uses autologous fat, unlike commercial filler materials, there are almost no side effects.

Except for a little swelling and bruising after the procedure, it can be said that there are no side effects at all.

Therefore, it can be considered safer than any other plastic surgery.

However, this is based on proper fat grafting, and if procedures that go against the principles are performed, side effects may sometimes occur, such as an uneven shape, hardening due to fat necrosis, inflammation, or an unnatural shape due to excessive injection.

This is a matter determined by the operator's experience and skill, and is absolutely not an overall problem with fat grafting.

Therefore, if the procedure is performed according to the principles, these side effects almost never occur.

How to perform fat grafting without side effects

Procedure in a sterile state	As with all surgeries, fat grafting must also be performed with completely sterilized instruments and materials. After the procedure, the inside of the suction cannula should be thoroughly cleaned with a brush so that no fat residue remains, and it should be disinfected with a high-pressure steam sterilizer. Anesthetic and saline solution must also be carefully managed so they are not contaminated. Thorough sterilization and material management can prevent bacterial infection and inflammation.
Several-stage fat refinement process	Fat refinement must completely remove impurities through several stages to maximize the effect. Harvested fat usually contains about 80% impurities, and only about 20% is actually usable. If the remaining impurities (blood, serum, anesthetic, oil, moisture, etc.) are not removed, the result will not be good no matter how well the graft is performed.
Pre-conditioning before fat grafting	A high survival rate should make it possible to achieve satisfactory results with a single procedure if possible. Fine fat must be evenly placed in multiple layers, and before that, space must be secured at the site where the fat will be grafted so that the previously grafted fat is not compressed by surrounding tissues, allowing it to survive well without pressure.
Precise and uniform grafting across multiple tissue layers	The expression of a soft and natural contour is the key to fat grafting. To express a soft contour, it is better to graft in a three-dimensional manner, distributing the fat evenly across multiple layers. The grafting positions include the subcutaneous layer, muscle layer, and fascia layer. Fat must be spread through the tissue as if sowing seeds evenly to obtain a soft contour without unevenness.

Procedures before and after fat grafting and postoperative care instructions

This is the pre- and post-procedure process for undergoing fat grafting surgery.

① Make a consultation appointment by phone or online.

② Visit at the scheduled consultation time and have the consultation.

③ If you want the procedure, make a surgery reservation immediately after the consultation and leave. You can also make a surgery reservation later by phone or online.

④ Visit 30 minutes before the scheduled surgery time, receive an explanation of the fat grafting procedure, and undergo design planning.

⑤ After the design is completed, change clothes and receive an intravenous injection for painless sleep anesthesia.

⑥ The fat grafting procedure time varies by area, and if multiple areas are treated at the same time, it may take longer. On average, it takes 30 minutes to as long as 2 hours.

⑦ After the procedure, you will receive antibiotic and anti-inflammatory injections and rest in the recovery room for about 30 minutes.

⑧ You will receive post-procedure precautions and schedule the next visit date.

⑨ Visit 2 days after the procedure to check the progress of the fat grafting area and disinfect the fat harvest site. Showering is possible starting 2 days after the procedure. Visit on the 7th day after the procedure to check the progress and remove the stitches from the fat harvest site (navel). If it is too far to come to the clinic, you do not have to visit.

⑩ If a second procedure is needed, you will visit and undergo it between 3 and 10 months later.

Features and pride of Duhan Plastic Surgery's micro fat clinic

All anesthesia is performed with local anesthesia (sleep anesthesia).

All fat grafting procedures, regardless of the area treated, are performed under local anesthesia.

Local anesthesia is performed together with sleep anesthesia, and the procedure can be performed without any pain during or after the anesthesia ends.

Depending on the area, hyaluronidase, a swelling-reducing agent, is mixed with the local anesthetic and administered.

Hyaluronidase is an expensive swelling-reducing agent with a tissue-fluid diffusion effect that makes swelling almost nonexistent immediately after the procedure.

We have a systematic and advanced fat grafting system.

The success of fat grafting depends on the survival rate.

To maximize the survival rate, the following are necessary.

○ Living fat cells must be harvested.

○ To increase fat purity, centrifuge refinement and removal of unnecessary oil are used to maximize purity.

○ Before fat grafting, subcutaneous tunneling at the graft site secures space for the fat to be grafted.

○ Micro fat grafting cannulas are used to perform precise and detailed fat grafting for each area.

○ A three-dimensional method with micro grafting across multiple layers increases the survival rate and creates a soft contour.

We select appropriate and diverse fat harvest sites.

The most commonly used area for fat harvesting is the lower abdomen. The lower abdomen is the first choice because it causes less pain after the procedure, has less swelling and bruising, and is a comfortable area for daily life.

In addition, if there is not enough fat in the lower abdomen or if there is another area preferred by the patient, fat is harvested from other areas as well. The area most commonly selected after the lower abdomen is the inner thigh, followed by the outer thigh.

There is no fixed rule as to which area is better for fat survival.

The results are similar regardless of where it is harvested, and while the area with the most subcutaneous fat on the body is ideal for fat harvesting, it is better to choose the harvest site by considering the amount of fat to be harvested and post-procedure activity.

The two-step refinement process of harvested fat maximizes the survival rate.

The harvested fat undergoes a two-step refinement process to remove impurities other than fat cells.

Among the impurities in harvested fat, the largest proportion is local anesthetic, followed by oil.

It also contains impurities such as serum and red blood cells.

In the first step, it goes through a centrifugation stage for about 3 to 4 minutes, and in the second step, it enters the oil removal process.

The parts refined by centrifugation are local anesthetic, red blood cells, serum, and so on.

Oil is removed manually through natural absorption.

Through the two-step refinement process, nearly 100% concentrated fat is obtained, maximizing the effect of fat grafting and increasing the survival rate as much as possible.

We secure space for fat grafting through subcutaneous tunneling.

Subcutaneous tunneling is a necessary process for securing space in advance at the site where fat will be grafted, for high fat survival and uniform grafting.

It is a process of creating space for fat grafting by repeatedly moving a fine probe under the skin in a fan-like pattern.

The effect of subcutaneous tunneling is to increase fat survival and prevent fat from clumping, creating a uniform and soft contour.

Three-dimensional micro fat grafting can achieve a soft and even facial contour.

Although there are exceptions by area, the basic method of fat grafting is three-dimensional.

By dividing the fat into multiple layers and grafting small amounts evenly in each area, the survival rate of the fat is increased, and the survival is made uniform to create a soft contour.

We use micro fat grafting cannulas for precise fat grafting.

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

The fat absorption rate was high, survival was not consistent, the contour became bumpy, and grafting was difficult in delicate areas such as under the eyes.

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

Our clinic uses the micro needle (micro graft cannula) developed in-house.

The micro needle is a special graft cannula used only here, enabling ultra-precise grafting.

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

Immediate molding after fat grafting helps create a uniform and soft facial contour.

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

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

Cryogenic sterile storage of the remaining fat simplifies the second procedure.

When a second procedure is performed more than 3 months after fat grafting, fat is not harvested again; instead, the fat left over after the first procedure is used.

The remaining fat after the first procedure is cryogenically frozen, sterilized, and stored.

For the second procedure, the stored fat is thawed and can be used more conveniently.

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

Thorough aftercare system

After fat grafting, we carefully monitor the progress until the fat has fully survived by providing thorough aftercare.

During follow-up observation, if necessary, we strive to minimize customer dissatisfaction through swelling-reduction injections, shape corrections, and molding.

http://www.microfat.net