Introduction

Autologous fat filling in the temples has gained significant popularity in recent years as a cosmetic procedure. This technique offers a natural - looking way to enhance the facial appearance by restoring volume to the temples, which can become hollow due to aging, weight loss, or genetic factors. In New York City, a bustling hub of cosmetic and plastic surgery, there are numerous institutions that offer this service. In this article, we will explore some of the top - ranked institutions for autologous fat filling in the temples in the city, as well as delve into the details of the procedure, its benefits, risks, and more.

Understanding Autologous Fat Filling in the Temples

What is Autologous Fat Filling?

Autologous fat filling, also known as autologous fat grafting or fat transfer, involves taking fat from one area of the patient's body, typically the abdomen, thighs, or hips, and transferring it to the temples. The process starts with liposuction to harvest the fat. The harvested fat is then processed to remove impurities and excess fluids, leaving behind pure fat cells. These fat cells are then injected into the temples to add volume and improve the overall facial contour.

According to the research paper “Fat Ful‘fill’ment: A Review of Autologous Fat Grafting,” this procedure has several advantages. Fat is a natural filler, so there is no risk of allergic reactions or rejection. It also offers a long - term solution for volume restoration, as the transferred fat can survive and integrate with the surrounding tissue.

Benefits of Autologous Fat Filling in the Temples

• Natural Appearance: Since the fat used is from the patient's own body, the results look and feel natural, providing a more harmonious facial appearance.
• Long - lasting Results: Once the transferred fat cells establish a blood supply in the temples, they can survive long - term, offering more permanent volume enhancement compared to some synthetic fillers.
• Two - in - one Procedure: It combines liposuction from an area with excess fat, such as the abdomen or thighs, which can improve the contour of that area while simultaneously adding volume to the temples.
• Low Risk of Complications: As the fat is autologous, the risk of allergic reactions or rejection is extremely low.

Pre - operative Considerations

Before undergoing autologous fat filling in the temples, patients need to have a thorough consultation with a qualified surgeon. During this consultation, the surgeon will review the patient's medical history, medications, and allergies. It is important to inform the surgeon about any medications that interfere with platelet function, as patients are usually instructed to stop these medications 2 weeks before the surgery and can restart them 1 week after the procedure. Laboratory tests are also typically done about 1 week before the procedure to ensure the patient is in good health for the surgery. Additionally, patients may be prescribed antibiotics before and after the surgery, such as cefadroxil, to prevent infection. In cases of a history of herpes labialis infection, antiviral medications like acyclovir may be given.

Ranking List of Institutions in New York City

Luxurgery

Luxurgery, led by Dr. Sachin Shridharani, is a well - known institution in New York City for autologous fat transfer procedures. Dr. Shridharani is board - certified by the American Board of Plastic Surgery and has years of experience serving Manhattan residents. The facility is accredited by the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), ensuring a high standard of safety and quality.

At Luxurgery, patients have the option to have their procedures performed at the office or at area hospitals and “surgicenters.” Dr. Shridharani offers personalized treatment plans tailored to each patient's body needs and aesthetic goals. The clinic provides a comprehensive service, from the initial consultation to post - operative care. For autologous fat filling in the temples, patients can expect a detailed assessment of their donor sites (such as the abdomen, waist, thighs, etc.) to determine the best source of fat for transfer. The clinic also offers in - depth information about the procedure, its potential results, and recovery process, helping patients make informed decisions.

Dr. Kolker's Practice

Dr. Adam Kolker is another prominent plastic surgeon in New York City specializing in facial fat transfer, including autologous fat filling in the temples. His office - based surgical suite is accredited by the AAAASF, which is a mark of quality and safety in the surgical facility.

During the initial consultation, Dr. Kolker conducts a thorough examination of the patient's skin and soft tissue relationships, paying close attention to factors such as skin tone, texture, elasticity, and the depth of folds and wrinkles. He then carefully plans the autologous fat graft or fat transfer techniques to achieve the most natural and desired result. Dr. Kolker has a comprehensive gallery of before - and - after photographs (viewable in the office) to give patients an idea of the potential outcomes. Many patients praise his precision and gentle touch, as well as the natural - looking results he achieves. After the procedure, he provides detailed post - operative care instructions and closely monitors patients' recovery.

Gotham Plastic Surgery

Gotham Plastic Surgery, under the leadership of Dr. Miller and other expert physicians, offers fat injection (fat grafting) as an alternative to artificial dermal filler materials. Their JCAHO - accredited office - based surgery facility provides a safe environment for the procedure.

The fat injection procedure at Gotham Plastic Surgery is typically completed in under an hour and can be performed with local anesthesia. Fat is harvested from an area of excess on the body, such as the outside of the leg or the stomach, using a very small cannula and gentle liposuction techniques. The harvested fat is then prepared and re - injected into the temples. The clinic also offers a variety of other plastic surgery and non - surgical cosmetic procedures, allowing patients to combine different treatments for a more comprehensive facial rejuvenation if desired. They emphasize creating custom treatment plans that meet each patient's unique aesthetic goals.

Dr. Mark H. Schwartz's Practice

Dr. Mark H. Schwartz, a New York City board - certified plastic surgeon, performs autologous fat transfer or liposculpture procedures, including for the temples. His office in New York City is the location where the procedures are carried out on an outpatient basis.

Dr. Schwartz has years of experience performing fat transplants and has refined his skills to produce superb results. During the fat grafting procedure for the temples, fat is taken from the donor area (such as the abdomen or thighs) using a small cannula under local anesthesia. The harvested fat is then purified, and only the fat cells are grafted into the temples. He also provides patients with guidance on post - operative care to minimize swelling and bruising and ensure the best possible outcome. His focus on patient safety and satisfaction makes his practice a popular choice for autologous fat filling in the temples.

Columbia University's Plastic & Reconstructive Surgery

Columbia University is one of New York's best hospitals and a world - class medical center. Their plastic and reconstructive surgery division has a team of highly skilled plastic surgeons proficient in multiple areas of specialization, including cosmetic procedures such as autologous fat filling in the temples.

The division is at the forefront of clinical and laboratory research in plastic surgery. This means that patients at Columbia can benefit from the latest techniques and advancements in the field. The plastic surgeons at Columbia take a comprehensive approach to patient care, from the initial consultation to the post - operative follow - up. They have experience dealing with complex cases and can provide personalized treatment plans based on the patient's overall health, facial structure, and aesthetic goals. The institution also offers a wide range of other plastic surgery and reconstructive services, making it a one - stop destination for various cosmetic and reconstructive needs.

Procedure Details

Donor Site Selection

Selecting the appropriate donor site for fat harvesting is crucial for the success of the autologous fat filling in the temples. Studies by Rohrich et al. and Ullmann et al. have shown that there may not be a single ideal donor site in terms of the viability of lipocytes within the fat grafts. However, adipose tissue has been identified as a source of processed lipoaspirate cells or adipose - derived stem cells (ADSCs). Padoin et al. evaluated that the lower abdomen and inner thigh have higher concentrations of these processed lipoaspirate cells, making them potentially better donor sites for adult ADSCs compared with other common donor sites. In the context of New York City institutions, surgeons often take into account the patient's body type, lifestyle, and personal preferences when selecting the donor site. For example, in female patients, the surgeon may prefer the thigh as a donor site if they are concerned about accidental asymmetry in the lower abdomen, as in the Indian setting where women may wear saris (as mentioned in the research paper), this concept can also be applied to patients with similar concerns in New York.

Harvesting Method

There are different methods for harvesting fat. In many cases, short general anesthesia is used to reduce patient anxiety and pain. The area to be suctioned is infiltrated with a solution, such as 500 ml of Ringer lactate with 0.5 cc of adrenaline. Smaller areas can be treated under tumescent anesthesia, while larger areas may require tumescent anesthesia with sedation. After infiltration, it is important to wait about 15 minutes to allow the epinephrine to take full effect and for the anesthesia to distribute evenly through the tissues. Many comprehensive studies support that the atraumatic technique for fat graft harvesting is superior to conventional liposuction. Blunt atraumatic fat grafting cannulas are often preferred as they cause less damage to the fat cells. A comprehensive study by Gonzalez et al. concluded that 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 compared with a 3 mm diameter blunt - tipped cannula connected to a 60 cc syringe.

Processing of the Fat

Once the fat is harvested, it needs to be processed to remove blood, oil, and other impurities. There are three primary methods used clinically: sedimentation by gravity, filtering technique, and centrifugation. While there is controversy among surgeons about the best method, comprehensive studies have shown that centrifugation, at 3000 rpm (about 1289 g) for 3 minutes, can clear the fat from most blood remnants and may maintain the highest concentration of stem cells within the processed lipoaspirates. Since stem cells or angiogenic growth factors may play a role in fat graft survival, this method is often considered a better choice. After centrifugation, the syringe shows layers, with a yellow supernatant and a blood - stained infranatant. The blood - stained fluid in the lower layer is removed before injection.

Placement of the Fat in the Temples

For the recipient site (the temples), the entry sites are first 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. A 10 cc syringe full of adipose tissue is then used for injection. Approximately 0.1 cc is injected with every pass, and the injection is carried out in an intermittent retrograde pattern while constantly verifying the evacuation of the syringe contents by its graduated scale. This fan - shaped reinjection should be done at various different levels in the temples to obtain a harmonious result and restore the previous anatomy of the site. The placement of fat grafts in different tissue planes has also been studied. For example, Karacaoglu et al. found in a rabbit face model that the survival of fat grafts is significantly higher if they are placed in the supra - muscular layer than in the subcutaneous or sub - muscular layer. However, some surgeons may prefer injecting the fat in the subcutaneous layer, believing that the survival of the grafts is better in this layer.

Post - operative Care and Recovery

After autologous fat filling in the temples, patients can expect some degree of swelling and bruising, which is normal and will gradually subside. The extent of swelling and the recovery time can vary from patient to patient. In general, patients may experience mild discomfort, but analgesics are often not required. Antibiotics and anti - inflammatories are usually prescribed post - operatively to prevent infection and reduce inflammation.

Most patients can go home the same day after the procedure. If the fat grafts are performed as an isolated procedure under local anesthesia, patients may be able to return to work in 2 - 3 days, although some may be able to return the next day. However, if the procedure is used to correct moderate or substantial volume deficiencies or is combined with other facial or body contouring procedures, the return to work may range from 7 - 14 days. Swelling is common after fat transfer and often resolves after 2 weeks, but it may take up to 12 weeks for the final results of the fat graft procedure to be evident. Light aerobic activity, such as elliptical training, walking, or cycling, can be resumed as early as 4 - 5 days following the fat grafts, and more strenuous activity can be begun at 2 - 3 weeks. Surgeons in New York City institutions closely monitor patients' recovery and provide guidance on any necessary follow - up treatments or care.

Potential Complications

Although autologous fat filling in the temples is generally a safe procedure, there are some potential complications that patients should be aware of. The most common complication is the absorption of fat, which can be addressed by some degree of over - correction during the procedure. However, unintentional over - correction can also occur, especially in the infra - orbital area, where visible nodules may develop. Superficial nodules can also result from the injection of an extremely large bolus of fat too superficially.

Other common complications include post - operative erythema, edema, bleeding, and ecchymosis. Infections following augmentation have been reported, so it is important for physicians to screen for and treat any active, chronic, or recurrent infections, particularly in adjacent facial areas such as the sinus, dental, or ocular regions, during the pre - operative period. The centrifuge can also be a source of infection, and it is recommended to use sterile centrifuge sleeves to decrease the chance of transmission.

Vascular occlusion or the development of emboli is the most serious complication associated with fat transplantation. There have been cases of blindness following transplantation in the glabellar region, as well as occlusion of the middle cerebral artery and ocular fat embolism after fat transplantation in the face. In the rare event that vascular compromise occurs, the patient should be placed in the Trendelenburg position, nitroglycerin paste should be applied, and the area should be massaged until blanching resolves. Fat hypertrophy following weight gain may occur after augmentation, which may require surgical revision to correct. Depressions, asymmetries, bulges, and fat necrosis leading to contour irregularities are also possible complications.

Conclusion

Autologous fat filling in the temples is a popular and effective cosmetic procedure that can enhance the facial appearance by restoring volume and providing a more youthful look. In New York City, there are several top - ranked institutions that offer this service, each with its own unique approach, experienced surgeons, and high - quality facilities. From Luxurgery, Dr. Kolker's practice, Gotham Plastic Surgery, Dr. Mark H. Schwartz's practice, to Columbia University's plastic and reconstructive surgery division, patients have a range of options to choose from based on their specific needs and preferences.

However, it is crucial for patients to thoroughly understand the procedure, including the pre - operative considerations, the details of the surgery, the post - operative care, and the potential complications. By choosing a qualified and experienced surgeon and following all the necessary instructions, patients can increase the chances of a successful outcome and enjoy the long - term benefits of autologous fat filling in the temples. If you are considering this procedure, we encourage you to schedule a consultation with one of the institutions mentioned in this article to learn more and determine if it is the right choice for you.