Introduction
Full - face autologous fat filling, also known as facial fat transfer or autologous fat grafting, has gained significant popularity in New York City. This procedure offers a natural way to rejuvenate the face, restore lost volume, and improve overall facial contours. In this article, we will explore the ranking of institutions and notable cases for full - face autologous fat filling in New York City, delving into the procedure, its benefits, potential risks, and the experiences of patients with different surgeons.
Understanding Full - face Autologous Fat Filling
What is Full - face Autologous Fat Filling?
Full - face autologous fat filling involves harvesting fat from one part of the patient's body, typically the abdomen, thighs, or buttocks, through liposuction. The harvested fat is then processed and purified before being injected into various areas of the face that have lost volume due to aging, weight loss, or other factors. This includes areas such as the cheeks, lips, nasolabial folds, and under - eye hollows. According to Dr. Kolker's website, “Facial fat transfer can find soft, youthful fullness again by replenishing areas that have lost volume over time.”
Benefits of Full - face Autologous Fat Filling
- Natural Results: Since the fat used is from the patient's own body, the results look and feel more natural compared to synthetic fillers. It blends seamlessly with the existing facial tissues, and over time, the fat can behave like normal facial fat. As per Zuckerman Plastic Surgery, “Facial fat grafting uses your own body fat, ensuring the results blend seamlessly with your natural facial features.”
- Long - lasting Effects: Unlike some fillers that need to be frequently replenished, the results of autologous fat filling can last for several years. Once the transferred fat cells establish a blood supply, they can remain in the face for a long time, providing a more permanent solution to volume loss.
- Improved Skin Quality: The transferred fat contains growth factors that can help improve the skin's texture and tone. It can make the skin look more hydrated, plump, and youthful, reducing the appearance of fine lines and wrinkles.
- Dual Benefit: It not only enhances the facial appearance but also reduces unwanted fat in the donor areas, acting as a form of body contouring in addition to facial rejuvenation.
Notable Institutions and Surgeons in New York City
Dr. Adam Kolker
Dr. Kolker is well - known for his expertise in facial fat transfer in New York City. During the initial consultation, he conducts a thorough examination of the patient's skin and soft tissue relationships. He carefully plans the autologous fat graft or fat transfer techniques, as well as the combination of cosmetic surgery and fat graft techniques, to achieve the most natural and desired result. His patients have reported high satisfaction rates. For example, one patient said, “My sole stipulation was that I look ‘natural’ and the fact that I had cosmetic surgery should not be obvious. Dr. Kolker recommended fat transfer to give me a ‘softer’ and more natural appearance. Now not only do I receive many compliments on my appearance, I finally look the way I feel.” Dr. Kolker's office - based surgical suite is accredited by the American Association for the Accreditation of Ambulatory Surgery Facilities (AAAASF), ensuring a high level of safety for patients.
Dr. William Lao
Dr. Lao, a graduate of Johns Hopkins Medical School, has provided facial procedures, including autologous fat grafting, to many patients. He has received numerous positive reviews from his patients. For instance, a 57 - year - old female who had her eyelids and face lifted, along with fat grafting, was 100% satisfied with the results. People told her she looked 10 years younger, and her confidence level soared. Dr. Lao also showed his aesthetic sense and medical skills when correcting uneven eyelids. He pointed out that a patient's upper eyelids were sunken and suggested a fat grafting procedure, which transformed the patient's eyes and exceeded her expectations.
Dr. Sachin Shridharani (Luxurgery)
At Luxurgery, Dr. Shridharani and his team are dedicated to providing high - quality treatment for fat transfer procedures. He has the ability to perform procedures at his office or at area hospitals and “surgicenters” in New York City, all with appropriate certification and accreditation. Ideal candidates for fat transfer with Dr. Shridharani are those at a healthy weight with a reasonable amount of body fat for donation. His patients can expect a personalized treatment plan. Dr. Shridharani also provides valuable pre - and post - operative tips to help maximize the chances of fat survival.
Dr. Joshua D. Zuckerman (Zuckerman Plastic Surgery)
Located on the prestigious upper east side of New York City, Dr. Zuckerman offers expert facial fat grafting injections. He provides a comprehensive consultation process, assessing the patient's facial structure, skin quality, and aesthetic goals. The procedure is performed under local anesthesia, often combined with sedation. Recovery is relatively quick, with most patients experiencing mild swelling and bruising that resolves within a week or two. His practice emphasizes natural - looking rejuvenation and long - lasting results, with patients able to return to normal activities shortly after the procedure.
Dr. David Cangello
Dr. Cangello was mentored by the pioneer of fat grafting techniques, Dr. Sydney Coleman. This specialized training and extensive experience allow him to produce superior results for fat transfer procedures in New York City. He can customize the fat transfer results to the patient's natural anatomy and cosmetic preferences. Dr. Cangello maintains a fully accredited surgical facility onsite in his NYC office and also has operating privileges at Lenox Hill Hospital and Manhattan Eye, Ear, and Throat Hospital. His patients have reported being extremely pleased with their autologous fat transfer results, praising his skills as both an artist and a medical doctor.
Case Studies
Case 1: A Gentleman's Facial Rejuvenation with Dr. Suzman
A 70 - year - old gentleman was dissatisfied with the signs of aging in his face. Fillers had a minor impact, but he did not want a full facelift. Dr. Suzman performed an office - based fat graft procedure, injecting about 18 cc of macro fat and 15 cc of nano fat into his cheek, nasolabial crease, and fine wrinkles. The result was a dramatic improvement. The fat not only restored volume but also had some permanent collagen and skin - building effects, lasting for years.
Case 2: Addressing Facial Volume Loss with Dr. Cangello
A patient with significant signs of facial aging and volume loss, but who did not want an entire facelift surgery, underwent an autologous fat grafting procedure with Dr. Cangello. Fat was removed from the tummy and thigh areas, filtered, and about 15 cc was injected into the cheek, chin, jawline, and lips. An additional 15 cc of nanofat was filtered and used with a microneedling technique to improve the skin texture and contour. This comprehensive approach achieved results that would have been impossible with other techniques such as fillers, lasers, ultherapy, or IPL.
Procedure Process
Pre - operative Planning
Pre - operative planning is crucial. As described in “Fat Ful‘fill’ment: A Review of Autologous Fat Grafting”, during the pre - operative consultation, medications and allergies are reviewed. Patients are instructed to stop all medications that interfere with platelet function two weeks prior to surgery and can restart them one week after the procedure. Appropriate laboratory tests are obtained approximately one week before the procedure. For example, patients may be asked to take 500 mg of cefadroxil the evening before the procedure and continue twice daily for one week. In cases with a history of previous herpes labialis infection, 400 mg of acyclovir is given in the morning of the procedure and then twice daily for one week. Diazepam may be given to anxious patients about one hour before the procedure.
Donor Site Selection
Studies have shown that while there is no conclusive evidence of a single favorable donor site, the lower abdomen and inner thighs may be better choices. Adipose tissue from these areas has been identified as a source of processed lipoaspirate cells or adipose - derived stem cells (ADSCs). As the reference article suggests, these areas have a higher concentration of stem cells, which may not only serve as fillers but also improve the quality of aged and scarred skin. Surgeons will also estimate the approximate amount of fat to be transplanted into each area and mark the liposuction area with the patient in a standing position after a sterile preparation.
Harvesting the Fat
There are various methods for harvesting fat. Most comprehensive studies support that the atraumatic technique is superior to conventional liposuction. A blunt atraumatic fat grafting cannula is often preferred. According to a study, the viability of fat grafts is significantly better when fat is harvested by a 2 mm diameter cannula with a blunt tip and several side holes connected to a 10 cc syringe as compared with a 3 mm diameter blunt - tipped cannula connected to a 60 cc syringe. The area to be suctioned is infiltrated with a solution containing ringer lactate and adrenaline. After infiltration, it is best to wait 15 minutes to allow the epinephrine to take full effect and for the anesthesia to infuse evenly through the tissues.
Processing the Fat
Processing the harvested fat is a controversial area. Three primary methods - sedimentation by gravity, filtering technique, and centrifugation - have been used clinically. Although centrifugation may be more aggressive on adipocytes, it can clear the fat from most blood remnants and possibly maintain the highest concentration of stem cells within the processed lipoaspirates. Centrifugation at 3000 rpm (about 1289 g) for 3 minutes is often considered a better method. After centrifugation, the blood - stained fluid in the lower layer is removed before injection.
Placement of the Fat Grafts
For recipient site anesthesia, the entry sites are anesthetized, and a regional nerve block may be given. A standard 18 - gauge needle is used to create the entry site, and local anesthesia is infiltrated with a blunt cannula. Approximately 0.1 cc of fat is injected with every pass in an intermittent retrograde pattern. The fat should be injected at various different levels to obtain a harmonious result and restore the previous anatomy of the site. Studies have shown that the survival of fat grafts may be significantly higher if they are placed in the supra - muscular layer than in the subcutaneous or sub - muscular layer, although some surgeons prefer injecting in the subcutaneous layer for better graft survival.
Recovery and Aftercare
Immediate Post - operative
Patients may experience swelling and bruising at both the donor and injection sites. According to different surgeons' experiences, patients who have a fat graft procedure under local anesthesia as an isolated procedure may be able to return to work in two or three days, while those who have it in conjunction with other facial or body contouring procedures may need seven to fourteen days off work. Light aerobic activity such as elliptical training, walking, or cycling may be resumed as early as four to five days following fat grafts, and more strenuous activity can be begun at two to three weeks.
Long - term
Swelling is very common after fat transfer and often resolves after two weeks, but it may take up to 12 weeks for the final results of the fat graft procedure to be evident. To maintain the results, patients are advised to follow a healthy lifestyle, protect their skin from the sun, and maintain a stable weight, as significant weight fluctuations can affect the longevity of the fat grafts. In some cases, additional procedures may be necessary to achieve an optimal result, as the overall take rate of fat grafting by even more experienced surgeons ranges from about 50 - 90%.
Potential Risks and Complications
Although full - face autologous fat filling is generally considered a safe procedure, there are potential risks and complications. According to “The Safety of Fat Grafting: An Institutional Retrospective Review”, in a case series of 396 patients who underwent fat grafting procedures from January 2015 through July 2018, 110 (27.8%) experienced complications. Some of the common complications include:
- Fat Absorption: This is the most common complication. It can be avoided by some over - correction, but unintentional over - correction can also be a problem, especially in the infra - orbital area where visible nodules may develop.
- Superficial Nodules: These can result from the injection of an extremely large bolus of fat too superficially.
- Post - operative Complications: Such as erythema, edema, bleeding, and ecchymosis are also possible.
- Infections: Infections following augmentation have been reported. Physicians need to screen for and treat active, chronic, or recurrent infections, particularly of adjacent facial areas such as sinus, dental, or ocular regions. There are also reports of the centrifuge serving as a source of infection with pseudomonas, so sterile centrifuge sleeves are recommended.
- Vascular Complications: Vascular occlusion or the development of emboli is the most serious complication. There have been reports of blindness, occlusion of the middle cerebral artery, and ocular fat embolism following fat transplantation in the face. To reduce the risk, surgeons are advised to use a blunt - tipped cannula, initial withdrawal prior to injection, 1 - cc syringes, and epinephrine in the anesthesia to promote vasoconstriction.
- Fat Hypertrophy: Following weight gain, fat hypertrophy may occur after augmentation, which may require surgical revision to correct.
- Contour Irregularities: Depressions, asymmetries, bulges, and fat necrosis may lead to contour irregularities. In some cases, surgical excision may be necessary to address these issues.
Ranking Considerations
When ranking institutions and surgeons for full - face autologous fat filling in New York City, several factors should be considered:
- Surgeon's Experience and Expertise: Surgeons who have extensive experience in performing fat grafting procedures are more likely to achieve better results. Those who have been mentored by pioneers in the field, like Dr. Cangello, may have an edge in terms of techniques and skills.
- Patient Satisfaction: High patient satisfaction rates, as evidenced by positive reviews and testimonials, are a strong indicator of the quality of service and results. Patients' before - and - after photos and personal accounts can provide valuable insights into the surgeon's capabilities.
- Institutional Accreditation: Institutions with proper accreditation, such as the American Association for the Accreditation of Ambulatory Surgery Facilities (AAAASF), ensure a high level of safety and quality control during the procedure.
- Innovation and Technique: Surgeons who stay updated with the latest techniques and research in autologous fat grafting, such as using nano - fat or more refined harvesting and processing methods, may offer better results and fewer complications.
- Complication Rate: A lower complication rate is a sign of a surgeon's proficiency and the institution's quality management. Surgeons who can minimize the risks associated with the procedure are more reliable.
Conclusion
Full - face autologous fat filling is a popular and effective cosmetic procedure in New York City, offering a natural and long - lasting solution for facial rejuvenation. Notable institutions and surgeons like Dr. Adam Kolker, Dr. William Lao, Dr. Sachin Shridharani, Dr. Joshua D. Zuckerman, and Dr. David Cangello have demonstrated their expertise through successful case studies and high patient satisfaction. However, it is important for patients to understand the procedure, its potential risks, and the recovery process. When considering full - face autologous fat filling, patients should carefully research and choose a qualified surgeon and an accredited institution based on multiple factors.
If you are interested in full - face autologous fat filling, we encourage you to schedule a consultation with a reputable surgeon in New York City. During the consultation, you can discuss your aesthetic goals, learn more about the procedure, and get a personalized treatment plan. Share this article with friends and family who may also be interested in this topic, and continue exploring our website for more information on cosmetic procedures and related health topics.
