Liposculpture Procedure Overview
Fat rejuvenates the face, thus liposculpture is an excellent additional procedure to balance tightening procedures. In tandem, these procedures aid in adding volume to an aging face. Volume loss is a well-described, universally-recognized cause of an aged facial appearance. Fat is particularly useful if someone is resistant to the idea of permanent implants or doesn’t want synthetic fillers.
Liposculpture involves the liposuction of approximately 20–250cc of fat under local anesthesia from either the abdomen, the outer thighs, or the knees, with the intention of placing it in various areas in the face. Fat is a living graft. If handled carefully, much of it stays in place, particularly when placed in areas that are not especially mobile, such as the cheeks and areas under the eyes. Fat can be placed around scars, in the jawline, neck, temples, brows, and forehead. There is more difficulty with fat retention in the lips than anywhere else and so much swelling is associated with it that we prefer to use synthetic filler around and in the lips.
After fat injection, the abdomen or outer thighs from where it is taken are swollen and leak fluids for approximately 36 hours. 250cc represents a relatively small amount. Most patients notice little to no change.
In the face, however, the changes are dramatic. Initially, swelling is obvious and lasts for a period of 7-14 days. Within approximately one month, the fat settles. Not all the fat stays and we can’t say how much is going to be present in any one patient for at least six months. Overcorrection and undercorrection are possibilities with fat injection—undercorrection is preferable and looks more natural as compared to overcorrection. Overcorrections can be managed either by liposuction or by subcision (the removal of fat using a sharp needle under anesthesia) and are rare. We have other means of addressing overcorrections, excess fat after liposculpture or fat transfer as well. Some of these have been presented at national meetings and continue to be investigated in our practice.