Facial Fat Grafting Duhan Plastic Surgery - Cheek Fat Grafting

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Cheek Fat Grafting

Cheek fat grafting is one of the contour surgeries that can bring a major improvement to the overall impression.

If the cheeks are gaunt and the zygomatic bones or jawbone stand out, fat grafting should be considered before bone surgery.

The final goal of fat grafting is to create a smooth, oval face without contours.

Indications for cheek fat grafting

A face that looks gaunt
A face with facial asymmetry
When wrinkle improvement is needed
Prominent zygomatic bones or hollowing of the cheeks below the zygomatic bones
An inverted triangular face
When contours have formed as a side effect of facial plastic surgery

Candidates for cheek fat grafting

Fat grafting procedure for cheek contouring

① Fat is harvested from areas where it is stored in large amounts, 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 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 the fat survival rate.

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

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

The amount of fat needed is measured in 1 cc syringes.

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

④ The fat is grafted into the anesthetized area.

Fat grafting is performed after creating space for the fat to be grafted once the tunneling process is complete.

The clinic uses its own micro needle (micro grafting cannula), developed in-house.

The micro needle is a special grafting cannula used only at this clinic, enabling ultra-precise grafting.

The principle of fat grafting is to distribute the fat evenly throughout the grafting area so that it does not clump together, while also maximizing the survival rate as much as possible.

Effects of Duhan fat grafting tunneling technique

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

A delicate and careful injection method allows for customized design.

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

★ Tunneling means using a micro needle just beneath the skin to create a space where the fat will go. Since space is made as if boring a tunnel and then fat is injected afterward, the fat does not sag in the direction of gravity or become lumpy even after all of it has been placed.

★ The tunneling technique includes the separation process of wrinkles, so fat is grafted beneath the separated wrinkles and the wrinkles improve more clearly than with fat grafting at other hospitals.

Examples of cheek fat grafting - a severely gaunt, wrinkled face

If the face looks gaunt, it appears older and the impression also looks worn out, so it is better for the cheeks to have a certain amount of fullness.

There is no other way to add fullness to the cheeks than fat grafting.

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

Examples of cheek fat grafting - a narrow inverted triangular face

If the face is inverted triangular, fat grafting can transform it into a fuller, more balanced face.

In such cases, fat grafting is performed from below the zygomatic bones to the jawline to create volume.

From the front, the facial shape can change into a more balanced one.

Examples of cheek fat grafting - when the zygomatic bones appear prominent

When the cheeks are lacking fullness or the sides are hollow, the zygomatic bones appear more prominent by comparison.

Before considering zygomatic reduction surgery to push the zygomatic bones inward because they appear prominent, you can first consider fat grafting to the cheeks below the zygomatic bones so that the zygomatic bones appear less prominent by comparison.

If cheek fat grafting provides enough corrective effect for the zygomatic bones, there is no need for difficult zygomatic bone surgery.

Examples of cheek fat grafting - square jaw cases

Even when the jaw angle is large and the face looks square, fat grafting can provide a corrective effect.

By grafting fat into the hollow area above the square jaw, a visual correction effect can be achieved without jawbone surgery.

As the cheeks become fuller, the square jaw area appears relatively less prominent.

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

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

Examples of cheek fat grafting - sunken side cheek line

When the sides of the face are sunken and hollow like a field ditch, the hollow area can be naturally filled in to create a smooth contour.

The side area of the cheeks is tightly attached to the bones and tissue, making it a very difficult area in which to create natural volume.

The most difficult technique and expertise in cheek fat grafting are required when filling in the sunken side line.

Examples of cheek fat grafting - in cases of facial asymmetry

Even in cases where one side of the face is sunken or facial asymmetry is caused by abnormal development of the jawbone or zygomatic bones, good results can be achieved with fat grafting.

By grafting fat only on the sunken side, or by applying different amounts to both sides, facial asymmetry can be corrected to a similar degree.

Examples of cheek fat grafting - gaunt cheeks in men

For men as well, if the face is angular or has hollows, it can look older or give too strong an impression.

For men, it is better to have a softer impression rather than a fierce, strong one.

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

Examples of cheek fat grafting - when contours occur after fat grafting at another hospital

People often tend to think fat grafting is very easy, but fat grafting is by no means a simple or easy procedure.

Fat grafting is a more demanding procedure than any other kind of plastic surgery, and it requires a very complex process along with a great deal of experience, expertise, and highly refined manual skill.

There may be many hospitals that perform fat grafting, but only a handful do it properly.

Fat grafting is easy to perform, but difficult to achieve proper results with.

If you undergo the procedure at a hospital that only imitates the method carelessly, it is easy to end up disappointed.

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

It is better not to undergo the procedure with someone who lacks experience or with a non-specialist who does not hold a board certification in plastic surgery.

Examples of cheek fat grafting - when the cheeks look bulging after fat grafting at another hospital

After fat grafting, there are cases where the cheeks appear saggy or bulging due to overinjection or excessive survival of the fat.

In such cases, the shape is corrected by removing fat with a micro cannula.

As a rule, the timing of removal is determined after 3 months, once the results have been checked.

However, if there is excessive overinjection and the shape is too unnatural, earlier removal may be necessary.

Micro suction for correcting fat grafting side effects

① The area to be suctioned is marked on the skin with a design.
② Painless sleep anesthesia is administered to eliminate pain during local anesthesia.
③ Local anesthesia is administered to the suction area.
④ An ultrasonic liposuction device is used to melt the fat.
⑤ A micro suction cannula is used to suction out necrotic tissue or melted fat.
⑥ After liposuction, the suction area is effectively compressed with a facial band.​

The area to be suctioned is marked on the skin with a design.

The design differs by person,

and the areas are planned according to where the side effect has occurred, such as the cheeks, jawline, or under the eyes.

A plan is made for which area will have how much fat removed.

An IV sedative is used for anesthesia through a vein in the arm.

Since local anesthesia can be painful,

if local anesthesia is administered after first entering a sedated state,

local anesthesia can be performed without pain.

After the local anesthesia is finished, the patient wakes up.

It usually takes about 5 minutes to fall asleep with sedation.

Sedation is different from general anesthesia,

it is a safe method of anesthesia and is used as an adjunct to local anesthesia.

The cannula is inserted from the edge of the area to be suctioned, and the fat is removed delicately and gently.

If the amount to be removed is large, the fat may be melted in advance with ultrasound and then suctioned with a micro cannula.

If the amount is not large and more delicate suction is needed, suction may be performed only with a micro suction cannula fitted with a syringe.

The main point of suction is to remove it evenly within the designed area without creating irregularities.

In cases of necrotic abscesses in the breast, necrosis is often extensive, so if suction cannot correct it, an incision may be necessary.

Precautions after micro liposuction

After cheek liposuction, wear a facial band for about 4 to 7 days to prevent sagging and reduce swelling and bruising.

For smaller areas such as under the eyes, a facial band is not specially worn; a small bandage with gauze is attached for only 1 to 2 days and then removed.

After that, there is no special care.

If there was infection or inflammation before the procedure, antibiotics and anti-inflammatory medication are prescribed.

Other procedures for removing overinjected fat

◈ AccuSculpt laser procedure

It is similar to the SmartLipo laser procedure, and is a device introduced later after the demand faded due to the inadequate effects of the SmartLipo laser procedure.

However, like the SmartLipo laser procedure, in most cases the effect is below expectations or nearly absent.

It can also cause severe swelling, and heat damage to the skin may occur.

New procedures should be approached with caution because many of them lure consumers with indiscriminate false and exaggerated advertising before their effectiveness or side effects have been verified.

Also, necrotic tissue or inflamed tissue cannot produce good results unless it is removed directly by inserting a suction cannula.

◈ SmartLipo laser procedure

This is a method of melting and removing subcutaneous fat using a laser.

The procedure effect is weak, so it is a method in which volume reduction is hardly noticeable.

Since fat must be removed exactly from the desired location in the desired amount, there is no more accurate method than directly removing fat by inserting a cannula.

The degree to which an externally applied laser passes through the skin and melts the subcutaneous fat beneath it is extremely weak or almost ineffective, so the desired results cannot be obtained with this method.

◈ Lipolysis procedure (PPC injection)

This method uses injections to dissolve fat, but depending on the drug, it is often either nearly ineffective or, when stronger drugs are used, it can cause the skin to become uneven.

Once a drug enters the body, it spreads outward.

There is no way to know where and how deep the drug will spread, and caution is needed because it often causes unwanted areas to sink or creates crater-like hollows in spots.

With any procedure, the desired result can only be obtained when the right amount of fat is removed from the right place under accurate design.

Trying to do contouring with fat-dissolving injections is a procedure from which little can be expected.

Do not be swayed by false and exaggerated advertising that has not been proven effective.

Advantages of correcting the cheeks with fat grafting

01. The procedure is simple.
02. Because your own tissue is grafted, there is no need to worry about side effects.
03. Because the skin is not incised, there is no need to worry about scars.
04. Because it uses your own tissue, the shape looks natural.
05. There is not much swelling or bruising.
06. You can return to daily life immediately after the procedure.
07. If the fat tissue survives, the effect can be maintained for a long time.

Points of caution when correcting cheek fullness with fat grafting

☆ Fat grafting requires skilled technique and experience.

There is a large difference in results depending on the practitioner's skill level, so incomplete fat grafting can actually worsen the impression and should be approached with caution.

☆ After facial fat grafting, bandages or taping are not applied.

Apart from swelling and slight bruising, makeup can be applied and normal daily life resumed immediately, but for 1 to 2 weeks the swelling may make things look a little awkward.

☆ Because running exercise after fat grafting negatively affects the survival rate of the fat, running should be avoided for about a month.

Avoid alcohol and smoking for about a week.

Except in cases where fat was harvested from the legs, walking, weight training, and stretching may be done after about a week.

☆ Since cheek fat grafting survives over a period of 3 months, during that time it is helpful for fat survival not to rub or press the cheeks strongly.

Number of cheek fat grafting procedures

Because cheek fat grafting is an area with a high survival rate, satisfactory results can usually be achieved with a single procedure.

In some cases, a second procedure is performed.

The second procedure is done between 3 and 10 months after the first, and when repeating the procedure, the fat that was harvested at the time of the first fat grafting is thawed and used.

However, if more than 10 months have passed before the second procedure, the fat must be harvested again.

Duration of cheek fat grafting effects

Some people say that fat grafting has no effect because much of the fat is absorbed, but when performed correctly, fat grafting can produce a satisfactory effect.

Fat grafting is a procedure that yields good results when performed based on skilled technique and experience.

If the grafted fat survives, it is no longer absorbed and remains as your own fat tissue for life, so it is considered one of the safest and most effective methods.

On average, one fat grafting procedure, and in rare cases two, can provide permanent and satisfying facial contour correction.

Misconceptions and issues regarding fat grafting

You may think that all results will be good if you undergo fat grafting, but that is absolutely not the case.

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

As with all surgeries, the results vary depending on the surgeon's experience and expertise.

Fat grafting is a more demanding procedure than any other plastic surgery, and it requires a very complex process along with experience, expertise, and highly refined manual skill.

There are only a handful of hospitals that perform fat grafting properly.

Fat grafting is a procedure that is easy to do but difficult to produce proper results with.

Pre- and post-procedure steps and care instructions after the procedure

These are the steps before and after undergoing fat grafting surgery.

① Make an appointment for consultation by phone or online.

② Visit at the scheduled consultation time and receive counseling.

③ If you wish to proceed with the procedure, make a surgery appointment immediately after the consultation and leave. You can also make a surgery appointment later by phone or online.

④ Arrive 30 minutes before the scheduled surgery time, receive an explanation of the fat grafting procedure, and have the design drawn.

⑤ After the design is completed, change clothes and receive an IV for painless sedation anesthesia.

⑥ Fat grafting time varies by area, and if multiple areas are treated at the same time, the procedure may take longer. On average, it takes from 30 minutes up to 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 be given post-procedure precautions and the date of your next visit will be scheduled.

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

⑩ If a second procedure is needed, you will visit and undergo the procedure between 3 months and 1 year later.

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