A review of the top regular institutions for autologous fat removal of tear troughs in New York City

Introduction

Tear trough deformity is a common cosmetic concern that can make individuals look tired or older than they actually are. The tear trough refers to the sunken area that forms beneath the lower eyelids, directly below the under - eye bags, and extends towards the cheeks. As we age, the skin under the eyes becomes thinner, subcutaneous fat volume is lost, and facial ligaments become lax, contributing to the prominence of the tear trough. Some individuals may also have a congenital lack of facial fat volume in this area.

Autologous fat removal or grafting for tear troughs is an effective treatment option. It involves using one's own fat as a filler to restore volume to the under - eye area, providing a more natural and long - lasting solution compared to some other methods. In New York City, there are several top - notch institutions and surgeons offering this procedure. This article will review these regular institutions and the procedures they offer.

Understanding Tear Trough Deformity

Causes of Tear Trough Deformity

• Aging: With age, the skin loses elasticity, subcutaneous fat volume decreases, and facial ligaments weaken. The fat that normally covers the tear trough area may descend, creating a hollow.
• Genetics: Some people are born with a congenital lack of facial fat volume in the tear trough area, resulting in under - eye hollows.
• Loss of Skin Elasticity: The skin around the eyes is thinner and more delicate than other parts of the face, making it more prone to losing volume and sagging.

Symptoms

The main symptom of tear trough deformity is the presence of a sunken area beneath the lower eyelids. This can give the appearance of dark circles, puffiness, and a tired look. It can also make the under - eye bags more prominent.

Autologous Fat Removal of Tear Troughs: An Overview

What is Autologous Fat Removal for Tear Troughs?

Autologous fat removal, also known as autologous fat grafting or fat injection, is a procedure where a sample of one's own fat is taken from areas such as the abdomen, hips, or thighs. The fat is then prepared and carefully re - injected into the tear trough area to plump up the skin and restore volume loss. This is a natural alternative to synthetic fillers.

Advantages of Autologous Fat Removal for Tear Troughs

Top Regular Institutions for Autologous Fat Removal of Tear Troughs in New York City

Dr. David Cangello's Practice

Dr. David Cangello is a plastic surgeon with extensive experience in treating tear trough deformities. While his practice is well - known for tear trough filler treatments (using hyaluronic acid - based fillers), he can also potentially offer autologous fat removal options.

Treatment Approach

During the consultation, Dr. Cangello will determine the best treatment approach based on the patient's specific needs, goals, and medical history. He will consider factors such as the degree of tear trough deformity, skin type, and overall facial anatomy. If autologous fat removal is deemed suitable, he will carefully harvest the fat from a donor site and inject it into the tear trough area with precision.

Patient Experiences

Patients have reported that Dr. Cangello is patient, takes the time to explain every detail, and makes them feel comfortable. His work is highly regarded, and patients are satisfied with the natural - looking results they achieve.

Dr. Haideh Hirmand's Practice

Dr. Hirmand offers micro - fat transfers to the eyelids, tear troughs, and peri - orbital areas. Her practice focuses on providing long - lasting and effective volume restoration around the eyes.

Hirmand Technique

She uses a labor - intensive technique for fat transplantation that is best suited for eyelid and peri - orbital rejuvenation. Fat is harvested fresh using custom - made small cannulas, processed to purify and concentrate the stem cell - enriched portion. Then, it is injected through access holes in very small quantities with special small - caliber blunt cannulas. This technique minimizes damage to the fat cells and the recipient tissue, resulting in a smooth full contour.

Advantages

There is very little “over - correction” with this technique, as most of the injected fat survives. The scars associated with the harvest and injection sites are tiny and often invisible as they heal well. The bruising and swelling are less with each transfer, and the recovery is faster.

Dr. Gerald Imber's Practice

Dr. Gerald Imber is an internationally renowned plastic surgeon who performs a full range of cosmetic surgery procedures, including fat transfer. He firmly believes that fat transfer is the best of all available fillers for volume restoration and facial rejuvenation.

Treatment Areas and Goals

Fat transfer can address volume loss in various areas of the face, including the tear trough. The goal is to inject fat in a manner that allows it to develop its own blood supply and be retained for permanent correction of defects. For tear trough treatment, Dr. Imber will carefully assess the patient's facial structure and determine the appropriate amount of fat to transfer.

Pre - treatment and Aftercare

Before the fat transfer, patients need to take a break from certain medications, avoid drinking and smoking. After the procedure, most patients can resume their daily routine with some restrictions in 24 hours. Slight bruising and swelling may occur, but they will subside over time. Dr. Imber will provide detailed aftercare instructions to ensure the best results.

Dr. Adam Kolker's Practice

Dr. Kolker offers facial fat transfer or autologous fat grafts in New York City. His practice focuses on using fat grafts to rejuvenate the face and restore volume to areas in need, including the tear trough.

Customized Treatment Plans

During the initial consultation, Dr. Kolker will thoroughly discuss the patient's desires and expectations. He will conduct a detailed examination of the skin and soft tissue relationships and help the patient plan the autologous fat graft or fat transfer techniques that will achieve the most natural and desired result. He will also answer all questions regarding the fat grafting process.

Recovery

Following facial fat transfer, patients can go home on the same day. If the fat grafts are performed as an isolated procedure under local anesthesia, patients may take two or three days off before returning to work. Swelling is common but usually resolves within two weeks, and the final results may take up to 12 weeks to be evident.

Dr. Sachin Shridharani's Practice (Luxurgery)

Dr. Sachin Shridharani at Luxurgery offers fat transfer procedures in New York City. His practice is known for providing personalized treatment plans and high - quality care.

Treatment Process

Dr. Shridharani will first assess the patient's body fat distribution and determine the best donor sites for fat harvesting. He will then perform liposuction to obtain the fat, process it, and inject it into the tear trough area. The procedure can be performed at his office or at area hospitals and “surgicenters” with appropriate accreditation.

Results and Aftercare

Patients can expect to see an overall change in contour and fullness within days after the procedure, but it takes six months to one year to see the final results. Dr. Shridharani will provide pre - and post - operative care instructions to maximize the chances of fat survival and a successful recovery.

The Procedure of Autologous Fat Removal for Tear Troughs

Pre - operative Planning

• Consultation: The patient will meet with the surgeon to discuss their goals, medical history, and any medications or allergies. The surgeon will assess the tear trough deformity and determine if the patient is a suitable candidate for autologous fat removal.
• Donor Site Selection: Areas such as the abdomen, hips, or thighs are commonly chosen as donor sites. The viability of lipocytes within the fat grafts from different donor sites may be considered equal, but some studies suggest that the lower abdomen and inner thighs may have a higher concentration of adipose - derived stem cells.
• Medical Tests: Appropriate laboratory tests will be obtained approximately 1 week before the procedure to ensure the patient's overall health.
• Medication and Lifestyle Adjustments: The patient will be instructed to stop taking medications that interfere with platelet function, such as blood thinners and non - steroidal anti - inflammatory drugs, at least 2 weeks before the surgery. Smoking and alcohol consumption should also be avoided.

Fat Harvesting

There are various methods for fat harvesting, but the atraumatic technique is often preferred. This involves using blunt atraumatic fat grafting cannulas to minimize damage to the fat cells. The area to be suctioned is infiltrated with a solution containing anesthetic and adrenaline. After waiting for the solution to take effect, the fat is harvested using a cannula attached to a syringe. The left hand makes a fold on the extraction site, and the needle is pushed through the skin in the middle of the adipose tissue. The right hand pulls out the syringe plunger, and the surgeon moves the cannula back and forth in a fan - shaped pattern to harvest the required amount of fat.

Fat Processing

Once the fat is harvested, it needs to be processed to remove blood and other impurities. There are three primary methods for processing fat grafts: sedimentation by gravity, filtering technique, and centrifugation. Centrifugation at 3000 rpm for 3 minutes is often considered a better method as it can clear the fat from most blood remnants and possibly maintain a higher concentration of stem cells within the processed lipoaspirates.

Fat Injection

For the recipient site (tear trough area), the entry sites are anesthetized, and a regional nerve block may be given. A syringe full of adipose tissue is used, and approximately 0.1 cc is injected with every pass in an intermittent retrograde pattern at various different levels to obtain a harmonious result and restore the previous anatomy of the site. This also ensures that the fat grafts have a maximal amount of contact with the vascularized tissue in the grafted area for better survival.

Recovery and Aftercare

Immediate Post - operative

After the procedure, it is normal to experience some mild swelling, bruising, and redness around the injection site and the donor site. These symptoms usually subside within a few days to a week. Ice packs can be used to reduce swelling, and over - the - counter pain medications may be prescribed if needed.

Activity Restrictions

Patients should avoid strenuous exercise, alcohol, and blood - thinning medications or supplements for at least 24 hours after the procedure. They should also avoid rubbing or massaging the injection site for at least 24 hours to prevent the filler from shifting. Light aerobic activity, such as walking or using an elliptical machine, can be resumed as early as four to five days following the procedure, while more strenuous activity should be postponed until two to three weeks later.

Long - term Recovery

The final results of autologous fat removal for tear troughs may take several months to become fully visible as the swelling and bruising subside and the fat cells settle in the new location. Some of the injected fat may be reabsorbed over time, and additional procedures may be necessary to achieve the optimal result. The surgeon will schedule follow - up appointments to monitor the patient's recovery and assess the results.

Potential Complications

Common Complications

• Fat Absorption: Some of the injected fat may be absorbed by the body, which can lead to a decrease in the volume of the treated area. Over - correction during the initial procedure can help compensate for this.
• Swelling and Bruising: Mild swelling and bruising are common and usually resolve within a few days to a week.
• Superficial Nodules: These can result from the injection of an extremely large bolus of fat too superficially. They may require additional treatment to correct.
• Post - operative Erythema and Oedema: Redness and swelling may occur and usually subside over time.

Serious Complications

• Infection: Infections following augmentation have been reported. The physician needs to screen for and treat any active, chronic, or recurrent infections before the procedure. If an infection occurs, appropriate antibiotics will be prescribed.
• Vascular Occlusion or Emboli: This is the most serious complication associated with fat transplantation. It can lead to blindness, occlusion of the middle cerebral artery, or other vascular problems. If blanching of the skin occurs, immediate treatment is required, such as placing the patient in the Trendelenburg position, applying nitroglycerin paste, and massaging the area.
• Fat Hypertrophy: Fat hypertrophy following weight gain may occur after augmentation, which may require surgical revision to correct.
• Fat Necrosis: This can lead to contour irregularities. In some cases, a growing liponecrotic pseudocyst may develop, which may need to be excised.

Cost Considerations

The cost of autologous fat removal for tear troughs in New York City can vary depending on several factors. These include the surgeon's experience and reputation, the complexity of the procedure, the amount of fat needed to be harvested and injected, and the facility where the procedure is performed. It is important for patients to have a detailed consultation with the surgeon to understand the total cost and any additional fees, such as anesthesia fees and post - operative care costs.

Conclusion

Autologous fat removal for tear troughs is a popular and effective cosmetic procedure that can restore volume to the under - eye area, reducing the appearance of dark circles and hollows and giving a more youthful and refreshed look. In New York City, there are several top - notch institutions and experienced surgeons offering this procedure. Dr. David Cangello, Dr. Haideh Hirmand, Dr. Gerald Imber, Dr. Adam Kolker, and Dr. Sachin Shridharani are among the professionals who provide high - quality autologous fat removal services.

Before undergoing the procedure, patients should thoroughly research the surgeon and the institution, have a detailed consultation to understand the procedure, potential risks, and expected results, and follow all pre - and post - operative instructions carefully. With proper planning and execution, autologous fat removal for tear troughs can help patients achieve their aesthetic goals and boost their confidence.

If you are considering autologous fat removal for tear troughs, we encourage you to schedule a consultation with one of the reputable surgeons in New York City. Take the time to discuss your concerns and expectations, and make an informed decision about your cosmetic treatment. You can also share this article with friends and family who may be interested in learning more about this procedure.