The ranking of hospitals for autologous fat filling of the face in New York City is updated!

Introduction to Autologous Fat Filling of the Face

Autologous fat filling of the face, also known as facial fat transfer or fat grafting, is a cosmetic procedure that has gained significant popularity in recent years. This technique involves harvesting fat cells from one area of the patient's body, such as the abdomen, thighs, or buttocks, and then injecting them into specific areas of the face to restore lost volume, smooth out wrinkles and creases, and enhance facial contours. The main advantage of autologous fat filling is that it uses the patient's own tissue, reducing the risk of allergic reactions or rejection.

As people age, they naturally lose volume in their faces. The soft tissue volume slowly dissipates, causing transitions between different facial areas, such as the nasolabial fold, the junction of the lower eyelid and cheek, and the marionette line, to become more pronounced. Full cheeks may lose their prominence, and lips may thin and wrinkle. Autologous fat filling offers a natural - looking solution to these issues by replenishing the lost volume and restoring a more youthful appearance.

Benefits of Autologous Fat Filling

• Natural Results: Since the fat is taken from the patient's own body, the results blend seamlessly with the natural facial features, providing a more natural look compared to some synthetic fillers.
• Long - Lasting: Once the fat cells have established a blood supply in the new location, they can last for a long time, often several years. In contrast, the effects of some other fillers may fade more quickly.
• Improved Skin Quality: The transferred fat can contain growth factors that help improve the skin's texture and tone.
• Dual Benefit: It not only enhances facial contours but also reduces unwanted fat in the donor areas.

Candidates for Autologous Fat Filling

Ideal candidates for autologous fat filling of the face are generally healthy individuals who meet the following criteria:

• They seek a natural method for facial enhancement without the use of synthetic materials.
• Have areas of facial volume loss that contribute to a tired or aged appearance, such as sunken cheeks, under - eye hollows, smile or frown lines, and nasolabial folds.
• Possess sufficient fat deposits in the donor areas for extraction.
• Are in good health and have realistic expectations about the effectiveness and outcomes of the procedure.

Ranking of Hospitals for Autologous Fat Filling of the Face in New York City

Factors Considered in the Ranking

When ranking hospitals for autologous fat filling of the face in New York City, several factors are taken into account:

• Surgeon's Expertise: The experience, skills, and reputation of the plastic surgeons performing the procedure are crucial. Surgeons with a high level of training, board certification, and a proven track record of successful autologous fat filling surgeries are preferred.
• Facility Accreditation: Hospitals and clinics should be accredited by recognized organizations, such as the American Association for the Accreditation of Ambulatory Surgery Facilities (AAAASF). This ensures that the facility meets certain standards of safety and quality.
• Patient Reviews and Testimonials: Feedback from previous patients can provide valuable insights into the quality of care, the results achieved, and the overall patient experience at a particular hospital or clinic.
• Range of Services: Hospitals that offer a comprehensive range of services related to autologous fat filling, including pre - operative consultation, post - operative care, and follow - up appointments, are more likely to provide a seamless and satisfactory patient experience.
• Technological Advancements: The use of advanced techniques and technologies in autologous fat filling, such as minimally invasive liposuction methods for fat harvesting and precise injection techniques, can improve the safety and effectiveness of the procedure.

Top Hospitals in New York City

Dr. Kolker's Practice

Dr. Adam Kolker is well - known for his expertise in facial fat transfer and fat grafting in New York City. During the initial consultation, he thoroughly discusses the patient's desires and expectations. He conducts a detailed examination of the skin and soft tissue relationships, paying close attention to factors such as skin tone, texture, elasticity, and the depth of folds and wrinkles. Dr. Kolker carefully plans the autologous fat graft or fat transfer techniques, as well as combinations of cosmetic surgery and fat graft techniques, to help patients achieve the most natural and desired results.

He maintains a comprehensive gallery of before - and - after photographs to show patients the potential outcomes of the procedure. Many patients have reported high satisfaction with Dr. Kolker's work, with testimonials highlighting his precision, gentle touch, and ability to produce natural - looking results. The procedures at his office - based surgical suite, accredited by the AAAASF, can be performed under local anesthesia for mild corrections or under light sedation or general anesthesia for more complex cases.

Recovery time after facial fat transfer at Dr. Kolker's practice varies depending on the extent of the procedure. For isolated procedures under local anesthesia, patients may take two to three days off work, while more extensive procedures combined with other facial or body contouring procedures may require a return to work in seven to fourteen days. Swelling is common but usually resolves within two weeks, although it may take up to 12 weeks for the final results to be evident.

Dr. Darrick Antell's Practice

Dr. Darrick Antell is one of the world's most respected and sought - after plastic surgeons. He has been trained at Stanford and Cornell University and has been named a “top plastic surgeon” by several prestigious magazines, including Harper's Bazaar, Town and Country, Vogue, and New York Magazine. Many new patients come to him through referrals, indicating high patient satisfaction.

Dr. Antell's approach to plastic surgery is to achieve subtle, beautiful results that naturally enhance facial features. His facial fat transfer procedure involves harvesting healthy fat cells from a donor site, such as the buttocks or thighs, using specialized and gentle techniques to ensure the cells are not damaged. The fat cells are then purified and injected at a specific depth in the skin tissue to add volume to the desired areas of the face.

The procedure is typically performed with local anesthesia and intravenous sedation or “twilight” sedation in his private operating room located across the street from the world - renowned Lenox Hill Hospital. The state - of - the - art outpatient surgery facility is fully accredited and designed for patient comfort. After the surgery, patients recover in his recovery suite and can usually return home the same day. Most patients experience some swelling and bruising, which subside within the first two weeks, and many are able to return to their normal daily activities within a day.

Zuckerman Plastic Surgery

Located in the prestigious upper east side of New York City, Zuckerman Plastic Surgery, under the leadership of Dr. Joshua D. Zuckerman, offers expert facial fat grafting injections. Dr. Zuckerman conducts a thorough assessment of the patient's facial structure, skin quality, and aesthetic goals during the consultation. He also evaluates potential donor sites for fat extraction.

The facial fat grafting procedure at Zuckerman Plastic Surgery is performed under local anesthesia, often combined with sedation. Fat is harvested using a gentle liposuction technique, purified, and then meticulously injected into the target areas of the face to restore volume and improve contours. The benefits of the procedure here include natural results, improved skin quality, long - lasting effects, and the dual benefit of reducing unwanted fat in donor areas while enhancing facial contours.

Recovery from facial fat grafting at this clinic is relatively quick. Most patients experience mild swelling and bruising at both the donor and injection sites, which typically resolve within a week or two. Patients can usually return to normal activities shortly after the procedure, with some minor restrictions. To maintain the results, patients are advised to follow a healthy lifestyle, protect their skin from the sun, and maintain a stable weight.

Gotham Plastic Surgery

Gotham Plastic Surgery offers fat injection procedures as an alternative to artificial dermal filler materials. Dr. Miller and the other doctors at Gotham perform fat injection procedures on an outpatient basis at their JCAHO - accredited office - based surgery facility. The procedure is typically completed in under an hour and may be performed with local anesthesia.

Fat is first 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 areas of the face. There is minimal downtime or recovery associated with fat injection at Gotham. Some minor swelling or bruising may occur, which typically resolves within 48 hours, and most patients experience little discomfort. Work and other normal activities can often be resumed the same or next day.

The Procedure of Autologous Fat Filling

Pre - operative Planning

Pre - operative planning is a critical step in the autologous fat filling process. During the consultation, the surgeon will review the patient's medical history, including any medications and allergies. Medications that interfere with lidocaine metabolism or platelet function need to be noted. Patients are usually instructed to stop taking medications that affect platelet function 2 weeks prior to surgery and can restart them 1 week after the procedure.

Appropriate laboratory tests are obtained approximately 1 week before the procedure to ensure the patient's overall health. If the patient has a history of previous herpes labialis infection, antiviral medications may be prescribed. Diazepam may be given to anxious patients approximately 1 hour before the procedure to help them relax.

The surgeon also selects the donor site for fat harvesting. Studies have shown that there may not be a clear “favorable” donor site in terms of fat cell viability, but areas like the lower abdomen and inner thighs are often preferred because they may have a higher concentration of adipose - derived stem cells. The surgeon estimates the approximate amount of fat to be transplanted into each area of the face and marks the areas for liposuction on the patient while they are in a standing position after a sterile preparation.

Fat Harvesting

Fat harvesting is typically performed using liposuction techniques. General anesthesia may be used to reduce the patient's anxiety and pain, especially for larger areas of fat extraction. After the area to be suctioned is infiltrated with a solution containing local anesthetic and adrenaline, it is important to wait for a certain period (usually about 15 minutes) to allow the epinephrine to take full effect and for the anesthesia to distribute evenly through the tissues.

There are various methods for harvesting fat, but the atraumatic technique is often preferred. Blunt atraumatic fat grafting cannulas are considered superior to conventional liposuction for fat harvesting. A comprehensive study found 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. The fat is harvested by making small incisions and using a gentle suctioning motion to remove the fat cells.

Fat Processing

Once the fat is harvested, it needs to be processed to remove any blood, oil, or other impurities and to prepare it for injection. There are three primary methods for processing fat grafts: sedimentation by gravity, filtering technique, and centrifugation. Although there is some debate among surgeons about the best method, centrifugation at 3000 rpm (about 1289 g) for 3 minutes appears to offer more benefits as it can clear the fat from most blood remnants and possibly maintain a higher concentration of stem cells within the processed lipoaspirates.

After centrifugation, the syringe will show layers, with a yellow supernatant (pure fat) and a blood - stained infranatant. The blood - stained fluid in the lower layer is removed before injection. Some surgeons prefer using a manual centrifuge as it is less harsh on the adipocytes and can still achieve a fairly good separation of blood and fat.

Fat Injection

For the 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. A 10 - cc syringe full of adipose tissue is then used for injection. Approximately 0.1 cc of fat is injected with each pass, and the injection is carried out in an intermittent retrograde pattern at various different levels to obtain a harmonious result and restore the previous anatomy of the site.

Studies have shown that placing fat grafts in different tissue planes can affect their survival. For example, placing fat grafts in the supra - muscular layer may result in a higher survival rate compared to the subcutaneous or sub - muscular layer in some cases. However, many surgeons prefer injecting the fat in the subcutaneous layer as they believe the survival of the grafts is better in this layer.

Recovery and Aftercare

Immediate Post - operative Period

After autologous fat filling of the face, patients typically experience some swelling and bruising at both the donor and injection sites. The degree of swelling and bruising can vary from patient to patient. Applying ice to the treated areas can help reduce swelling. Patients are usually given discharge instructions that include details on how to care for the incisions at the donor site and the injection sites on the face.

If the procedure was performed under general anesthesia or “twilight” sedation, patients need to have an escort to bring them home and are advised not to drive for 24 hours after the administration of anesthesia. In some cases, antibiotics and anti - inflammatories may be prescribed to prevent infection and reduce inflammation. Most patients do not require strong analgesics as the pain is usually mild.

Return to Normal Activities

The recovery time and the ability to return to normal activities depend on the extent of the procedure. For less extensive autologous fat filling procedures, patients may be able to return to work within a day or two, especially if they have minimal swelling and discomfort. However, for more complex procedures or those combined with other facial surgeries, the return to work may range from seven to fourteen days.

Light aerobic activity, such as elliptical training, walking, or cycling, may be resumed as early as four to five days following the fat grafting procedure. More strenuous activity should be avoided for two to three weeks to allow the body to heal properly. The final results of the autologous fat filling may not be visible for up to a month due to residual swelling.

Long - term Aftercare

To maintain the results of autologous fat filling, patients are advised to follow a healthy lifestyle. This includes protecting the skin from the sun by using sunscreen with a high SPF, wearing protective clothing, and avoiding excessive sun exposure. Maintaining a stable weight is also important, as significant weight fluctuations can affect the longevity of the fat grafts. Weight gain may cause the fat cells to expand, while weight loss may lead to a reduction in the volume of the fat grafts.

Regular follow - up appointments with the surgeon are crucial. The surgeon will monitor the patient's recovery, check the results of the procedure, and address any concerns or complications that may arise. In some cases, additional fat grafting procedures may be recommended to achieve the optimal results.

Complications and Risks

Common Complications

Although autologous fat filling is generally considered a safe procedure, there are some potential complications:

• Fat Absorption: Some of the transplanted fat cells may not survive, and over time, the volume of the fat grafts may decrease. This can be addressed by over - correcting the initial injection to account for possible absorption.
• Superficial Nodules: Injecting an extremely large bolus of fat too superficially can result in the formation of visible nodules, especially in the infra - orbital area.
• Post - operative Erythema, Oedema, Bleeding, and Ecchymosis: These are common after the procedure but usually resolve within a few days to weeks.
• Infection: There is a risk of infection following augmentation. The physician needs to screen for and treat any active, chronic, or recurrent infections, particularly in adjacent facial areas such as the sinuses, teeth, or eyes, before the procedure. In rare cases, the centrifuge used in fat processing can be a source of infection, so sterile centrifuge sleeves are recommended.

Serious Complications

Vascular occlusion or the development of emboli is the most serious complication associated with autologous fat filling. Fat injection in the face can potentially lead to the occlusion of blood vessels, which can cause blindness, stroke, or other severe consequences. For example, a case of blindness following transplantation in the glabellar region has been reported. To minimize this risk, physicians are recommended to use blunt - tipped cannulas, withdraw the needle slightly before injection, use 1 - cc syringes, and include epinephrine in the anesthesia to promote vasoconst