Founder/Director of Noonopi Plastic Surgery, Seoul
Table of Contents
Facial fat grafting is a treatment that fills the volume of the aged face, a commonly performed procedure at Korean Plastic Surgery Clinic. We would like to introduce cases of fat transfer around eyes performed at Noonopi Plastic Surgery Korea.
1. What is a facial fat grafting
Facial fat grafting, a procedure commonly carried out at Korean Plastic Surgery Clinics, involves restoring volume to specific areas of the face that have lost volume due to aging or congenital factors.
This procedure, typically performed under sedation, follows a process of collecting fat, purifying it through centrifugation, and then injecting it into the desired areas.
To ensure the success of the procedure, it’s crucial to disperse the injected fat into multiple layers rather than depositing it in a single lump.
This method promotes better integration of the fat cells with the surrounding tissues, enhancing the overall outcome. Failure to follow these principles can result in the premature disappearance of the fat graft or a shorter maintenance period.
1) Fat harvest
The fat used for grafting can be harvested from various parts of the body, frequently in the lower abdomen or thighs.
2) Injection site
Injection sites for fat grafting can vary, and the process may differ slightly from doctor to doctor, affecting the survival rate and ultimately the results. Experience plays a significant role in fat grafting outcomes, making it a field that demands skill and expertise.
Dr. Nk Park has performed surgery using the same method for a long time and has accumulated data his results. This is why Noonopi Plastic Surgery provides satisfactory fat grafting results based on evidence.
3) Differences from filler
Fat grafting differs from using fillers in that it utilizes internal tissue, making it more compatible with the body over time. However, it’s important to note that aesthetic procedures on areas previously treated with fillers can be more challenging, potentially yielding less desirable outcomes.
While both fat grafting and fillers aim to restore volume, the skill level of the practitioner tends to have a greater impact on fat grafting outcomes compared to filler injections. Despite requiring more time and effort due to the fat harvesting process, fat grafting offers advantages in terms of longevity and natural integration with the body’s tissues.
2. What exactly is Nano fat?
Well, it’s essentially fat that’s been finely processed to create smaller particles. Typically, fat that’s been treated through centrifugation still contains adipocytes (the volume component) along with various nutrients like stem cell components and growth factors.
However, nanofat takes it a step further. It’s passed through ultra-fine filters, removing all fat cells and leaving behind just the beneficial nutrients.
This refined form of fat, produced through this process, is particularly effective in addressing issues like dark circles under the eyes. Noonopi Plastic Surgery actively utilizes this technique as part of its facial rejuvenation treatments. You can find more about Nano-fat on our website.
3. Principles of fat injection at Noonopi Plastic Surgery
The patients often raise questions about whether the fat injection results will fade over time. However, sticking to basic principles, meticulously analyzing records, and continually seeking areas for improvement can lead to long-lasting, successful outcomes.
The case above is my mother with lower blepharoplasty and facial fat transfer after 2 years.
In our approach, meticulous planning is crucial.
For instance, in the documented surgery record, shared with our nursing staff, we outline the precise sequence of procedures, such as lower eyelid surgery and fat grafting, to be performed simultaneously. Notably, in the case of the under-eye area, combining fat grafting with the injection of a stem cell component known as SVF has shown remarkable long-term results.
Equally important in fat transplantation is having the right tools.
1) Equipment
Our clinic uses Tulip instruments, renowned for precision in the surgical instrument market, contributing to the overall success and longevity of the results.
a) Fat Harvesting Cannula
The specifications of the cannula—thickness, hole size, and length—vary based on the intended use of the fat and the collection area. For fat grafting at Noonopi Plastic Surgery, we employ the Carraway Harvester with a diameter of 2.4mm (13G) for standard fat grafting. For nano fat grafting, we utilize a specialized cannula. Essentially, the size of the cannula holes is tailored to the specific purpose during the collection phase.
b) Nano Fat Transfer
Nano fat, collected through finer holes, undergoes centrifugation and is gradually resized. The process involves passing it through a filter to extract only the stem cell components, excluding the volume components. This ensures the prevention of lumpiness in the under-eye area post-fat transplantation.
c) Fat injection Cannula
Different cannulas are employed for fat grafting depending on the area.
Typically, 18G and 20G cannulas are used for facial fat grafting.
d) Centrifugation
Centrifugal separation equipment varies in cost, but we recommend equipment like our Metrigen 5250MG model, which allows for settings adjustment for both RPM and gravity force (relative centrifugal force).
2) Method for fat collection
Traditional textbooks advise against excessive negative pressure during fat harvest to avoid cell damage.
However, during my time working in various Gangnam plastic surgery clinics before opening my own, I noticed that none of them followed these textbook rules. Although I believe that guidelines may not always be the ultimate solution, however, at Noonopi Plastic Surgery, we prioritize minimizing cell damage by reducing the negative pressure during fat extraction, aligning with standard practices. Our confidence in this method stems from its consistent use over time, resulting in more predictable outcomes.
3) Method of fat transfer
The key principle of fat injection is to administer small amounts using a fine syringe to ensure seamless integration. Rather than pushing the syringe with your thumb, as depicted in the image below, it’s preferable to apply pressure with the heel of your hand.
This technique prevents the release of an excessive amount of fat at once, promoting smoother results.
4) Post-procedure care
While it’s generally discouraged to apply ice packs after fat grafting, minimal use may be acceptable, especially when the procedure is performed concurrently with other surgeries.
5) Hyperbaric oxygen treatment
At Noonopi Plastic Surgery, we offer hyperbaric oxygen treatment when necessary to enhance the engraftment rate following fat transplantation. However, individuals diagnosed with pneumothorax, atelectasis, or glaucoma should refrain from this treatment. Moreover, caution is advised for those using hearing aids or metal products, as their use may be restricted during hyperbaric oxygen therapy.
4. Case of fat transplant around eyes
1) Upper eyelid Fat grafting
For middle-aged individuals seeking eye surgery, forehead lift surgery offers significant advantages. But there is one drawback…
That is, the area above the eyes may appear sunken after surgery in some individuals. This is not caused by the surgery itself, but rather by the natural consequence of raising the eyebrows. The sunken appearance of the upper lids, hidden by sagging eyebrows, becomes visible only after the brows are raised. Noonopi Plastic Surgery forecasts and catches small details, recommending fat grafting for brow lift patients who are expected to have less orbital fat.
The above patient underwent a forehead lift, lower eyelid surgery, and fat grafting above and below the eyes at Noonopi Plastic Surgery Clinic six weeks ago. As previously mentioned, before the surgery, the presence of saggy eyebrows obscured the sunken appearance, but after the forehead lift, this sunken appearance became noticeable as forehead are lifted with hands(below photo).
So this case involved performing fat grafting above the eyes simultaneously with a forehead lift procedure. This decision was made because sagging of the eyelids was anticipated in the area indicated by the yellow arrow.
Similarly, other case with a forehead lift with upper lid fat injection are shown in the above.
The above case underwent upper blepharoplasty with sleepy eye correction procedures, along with fat grafting on the temples, under the eyes, and above the eyes. She appears significantly younger after receiving fat grafting on her upper eyelids.
2) Fat grafting under eyes
Next case involves an individual who previously underwent lower eyelid surgery. Despite a lack of fat, furrows, and sagging skin remained under the eyes. To address this, nano fat grafting was performed under the eyes simultaneously with lower eyelid revision surgery.
The last case where excessive fat was removed from under the eyes during a previous lower blepharoplasty. In the past, the concept of fat redistribution was not widely recognized, leading to the misbelief that removing fat was the correct approach. At Noonopi Plastic Surgery, we have successfully achieved positive outcomes for her through lower eyelid revision and lower lid fat grafting.
5. Cost of under-eye fat grafting
Indeed, the cost of under-eye fat grafting reflects the intricacy and care required in the procedure. Factors such as the specialized equipment, expertise of the medical team, and the meticulous planning involved contribute to the overall expense. Additionally, achieving satisfactory and long-lasting results demands precision and skill, which further justifies the investment. While the upfront cost may seem high, the benefits of natural-looking rejuvenation and enhanced confidence often outweigh the financial considerations for many individuals.
6. Conclusion
Fat grafting may appear straightforward, but it involves careful consideration of various factors. The selection of equipment must be meticulous, and achieving stable results requires time and attention to detail. Factors such as the depth and quantity of fat to be injected, as well as the potential for absorption, must be thoroughly assessed.
Did this article provide you with a better understanding of fat grafting? If you are willing to have an online consultation about additional topics, please don’t hesitate to reach out to us through e-mail: drnkpark@noonopi.com or WhatsApp +82-10-5406-0112.