Liposculpture (Facial Fat Transfer)

Aging is about gravity, skin changes, and volume loss. As we get older, the superficial and deep layers of fat in the face undergo atrophy and the face gains new shadows and hollows, and the bones that support facial structures become more visible. Wrinkle creams and skin treatments may improve the fine lines, and neurotoxins can smooth out the dynamic lines that occur with facial expression, but often the problem is more than skin deep. Injectable dermal fillers—hyaluronic acid or calcium hydroxyapatite (Radiesse®)can only temporarily restore facial volume in areas like small hollows or fine lines. Liposculpture—the transfer of particulate fat to restore volume to the face– is a more permanent, and potentially more natural solution.

Dr. Allan E. Wulc is a liposculpture expert in the Philadelphia area with more than 25 years of experience in cosmetic and plastic surgery. He is quadruple certified and the lead surgeon at W Cosmetic Surgery®. Dr. Wulc’s work is featured in presentations, lectures, and publications around the world. He has lectured nationally on refinements in techniques of facial liposculpture.

What is Liposculpture?

Liposculpture is a natural facial rejuvenation method.  Fat is suctioned from a problem area—somewhere where the fat is most hardy and troublesome to lose—washed, refined, purified, and sized into varied-sized particles for graft implantation into the face.  Using a device like the Hogue prism particle sizer, fat is partitioned into millifat for structural augmentation and lifting, into microfat to be placed more superficially in the fat compartments that lie closer to the skin, and into small particulate fat to be placed even more superficially with the intention of producing regenerative changes in the skin.   Fat is conservatively placed into selected regions of the face, such as the cheeks, eyebrows, temples, nasolabial creases, and jawline.

Dr. Wulc’s liposculpture technique can help improve the quality and texture of the skin while improving hollows and drooping skin.   Results from fat injections using the liposculpture technique generally last longer and are less expensive than synthetic fillers—especially over time. Facial fat grafting is particularly useful in patients who want to avoid permanent implants or artificial fillers.

Liposculpture Surgery Results

Liposculpture produces a natural look and feel. Some typical results of treatment using liposculpture are featured in our liposculpture gallery.

*Each patient is unique and individual results may vary.

Benefits of Liposculpture

Fat naturally provides your skin with substance, shape, and contour. Why choose liposculpture over synthetic fillers?

• There are growth factors in harvested fat.  , It is not clear as  to whether the fat that is grafted survives or whether the growth factors in the transplanted tissue act on surrounding fat to produce tissue regeneration. 
• Fat adds volume to the aging face, including sagging eyelids, cheeks, and facial hollows in quantities that would be much more expensive if synthetic fillers were chosen that only produce temporary results.
• Liposuctionj of the donor site allows us to perform body contouring and smooth the waistline or address fat excesses in the hips or love handles simultaneous with finding a new home for it in the face.
• Small particulate fat can be altered mechanically to create fraction of tissue that is more dense in growth factors and progenitor cells (SVF) that can used to fill scars caused by surgery, injury, or acne.
• Liposculpture can restore volume in cases where the skin of the face or eyelids have been overly and unnaturally tightened and recreate softness in areas of scarring or atrophy.
• Fat is completely natural and biocompatible
• Lipoculpture seems to  improve the general texture of the skin.  

Dr. Wulc specializes in liposculpture and has performed this procedure for more than 20 years.  The entire technique has evolved, and we are attuned to the changes and have developed specialized techniques which we feel improve the take of the fat and enhance the overall results.

Your Liposculpture Consultation

Dr. Wulc specializes in liposculpture (facial fat transfer), which can improve facial contours and restore volume to the face. Prior to the procedure, all patients are seen in liposculpture consultation with Dr. Wulc in our Philadelphia office. The consultation is a private meeting for you to discuss your goals, have your candidacy assessed, and ask any questions you may have about the procedure. Dr. Wulc will examine your skin and facial structure to determine the treatment options that can help you reach your goals.  Not everyone benefits from the technique and we will show you typical results of our patients as they recover from surgery and show you their long term results.

Who is a Good Candidate?

Good candidates for liposculpture fat transfer are men and women in overall good health who do not smoke, are near their ideal weight and have good skin elasticity. All plastic surgery results vary and are based on the specific needs and goals of each patient. Dr. Wulc will review realistic expectations with you during your initial consultation.

We have found that fat is not useful for rejuvenating the lips because it cannot survive in a host site where movement (e.g. swallowing, chewing and speaking) occurs. Fat may sometimes “take” in these locations, but it is associated with tremendous swelling which rarely justifies the outcome. We rarely put fat in the lips for this reason and suggest temporary dermal fillers as an alternative.

Facial Fat Grafting Procedure

The entire treatment can be performed under local anesthesia. Patients often opt for minimal sedation.  After the local is administered, Dr. Wulc begins with a gentle liposuction technique to harvest the fat cells needed for facial fat transfer. We create small incisions in inconspicuous areas of the body and inserts a cannula to suction and extract approximately 20–250cc of excess fat from the abdomen, love handles, buttocks, outer thighs, or knees. The area to be used and the approximate amount to be harvested will be discussed with you during your consultation.

Once the necessary amount of fat has been removed, Dr. Wulc processes the fat cells gently and carefully. In select cases, we may add growth factors into the harvested fat from your blood (PRP) to enhance the survival of the grafts.

Dr. Wulc then injects the purified sized fat into facial hollows using a small blunt cannula to fill areas like dark circles under the eyes, specific scars or defects. Larger amounts of fat are also grafted to replace lost volume in the eyebrows, cheeks, jawline and specific treatment areas, all using sized fat and atraumatic blunt cannulas.

*Each patient is unique and individual results may vary.

Facial Liposculpture Recovery in Philadelphia

Liposculpture recovery times vary. Most patients take seven to ten days to allow themselves to recover before returning to work or social activities. The initial swelling gradually subsides during the first three weeks, but the final results will not be visible until at least six months have passed.  Improvement seems to continue for up to 24 months.    

The area or areas where the fat was removed is generally swollen and leaks fluid for about 36 hours. 250cc represents a relatively small amount of fat and most patients notice little to no change in the areas that have been suctioned. 

Not all the fat will survive and establish itself in the new location. We can’t say how many fat cells will become permanent in any one patient for at least six months. Over and under-correction are possibilities during facial fat grafting. Undercorrection is preferable because the results look more natural than overcorrection. Overcorrections are rare and can be fixed either with a simple liposuction procedure or with subcision (the removal of fat using a sharp needle while the patient is under anesthesia). We have other means of addressing overcorrections as well. Some of these have been presented at national meetings and continue to be investigated in our practice. We will share with you multiple before and after photos during your consultation so that you are aware of how you look during your recovery and of your potential results.

Facial Fat Transfer FAQs

Am I a good candidate for liposculpture in Philadelphia?

You may be a candidate for facial fat grafting if you have signs of aging and would like to restore volume to your face or minimize lines and wrinkles. Good candidates have areas of the body with unwanted excess fat that stubbornly resists diet and exercise. If you are concerned about synthetic dermal fillers, a facelift, or implants, but would like to have significant long-lasting results, fat grafting may be right for you.

What is liposuction?

Liposuction is an extremely popular plastic surgery that is perfect for contouring specific areas of the body and resolving stubborn fat. Liposuction involves the permanent removal of fat cells from beneath the skin using a suction tube called a cannula. During the surgery, we remove fat by passing the cannula back and forth beneath the surface of the skin through small incisions. Major blood vessels and nerves are not affected by the blunt tip of the cannula. Each incision is less than a quarter of an inch, and typically no stitches are required. It is important to note that although liposuction is a fat removal procedure, it is not a substitute for dieting, supervised weight loss or exercise. 

What is fat grafting?

Fat grafting is the transplantation of fat cells from one area of the body to another. The fat is collected from an area with excess fat using liposuction technique before it is injected into areas of lost volume in the face. Over time, the grafted fat establishes itself under the skin to provide fullness and increased volume.

How long will my liposculpture results last?

Liposculpture fat grafting results are long-lasting.  This makes the procedure a more attractive option for some patients than temporary fillers, which are reabsorbed into the system and must be completed approximately every 12-18 months. Liposuction results will also be semi-permanent unless one gains weight.

Transplanted fat in the face will also likely expand if you gain weight, so it is essential to maintain your weight after the surgery. Dr. Wulc will explain the details of your procedure and provide you with realistic expectations during your consultation.

What are the alternatives to liposculpture?

Facial fat transfer is the most natural and permanent solution for replacing lost fat and rejuvenating the face. Alternative cosmetic procedures could include facial implants. Commercial dermal fillers may be used to enhance facial volume and may last one to two years.

What are the risks of liposculpture?

Risks may include the appearance of cellulite caused by dimpling of the skin or fat lobules. Bleeding is minimal, and bruises are expected but gradually fade over the first several weeks. Numbness of the skin is not expected but would likely resolve within a few weeks. There is a potential for over- or under-injection, which is based in part on the judgment of the surgeon and partly on the healing process. Dr. Wulc will explain all the risks of this procedure to you in detail at the time of your consultation.

Coolsculpting, Cool Mini, Kybella and Thermitight face tightening in Philadelphia

Every one of these procedures (except Kybella) all presume to tighten the neck.  All of these procedures produce some improvement. It is difficult to say without a consultation which of these procedures is going to be effective in your case.  In your consultation with us, we will advise you if any of these procedures will be enough to benefit you. If you have already had one of these procedures and are not completely satisfied, a consultation with us will also give you information to determine whether your choice was appropriate and, more importantly,  whether additional treatment or another technique might be of greater benefit.

Related Articles

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• Chin Up! You May Be Able to Skip a Facelift (or at Least Postpone it)
• “Holloween”: Trick and Treat
• Fillers & Cosmetic Surgery: How Long Will My Results Last?
• Carol’s Facial Plastic Surgery

Call for a Liposculpture Consultation in Philadelphia

Dr. Allan E. Wulc performs liposculpture surgery in Philadelphia at W Cosmetic Surgery®. Call (610) 828-8880 or visit W Cosmetic Surgery to schedule a consultation online. We look forward to meeting you. Serving customers from Plymouth, Philadelphia, Main Line, PA and surrounding areas.

Why choose Dr. Allan Wulc

He is board-certified in :

• Ophthalmology by the American Board of Ophthalmology
• Cosmetic Surgery, Facial by the American Board of Cosmetic Surgery
• Plastic Surgery by the American Board of Physican Specialties
• a diplomate of the American Society of Ophthalmic Plastic and Reconstructive Surgeons.