Joseph T Cruise, MD's Fat Transfer Philosophy

Fat transplantation is the treatment of choice for permanent soft tissue filling about the face. I have been doing it for quite some time and have found that by gentle harvesting of the fat, usually from the abdomen, and proper transfer well over 60 per cent of the fat survives forever. It is an excellent option to enhance cheeks without implants. I have found that when I fill in areas around the cheeks and eyes it acts like filling up a balloon with water. As the balloon fills it becomes very smooth and tight. The same happens when fat is added to the loose skin around the eyes. The small wrinkles and even some of the larger ones go way or are diminished markedly.

The nice thing about fat transplant is that it can be repeated until the desired effect is obtained. Because fat is continually lost and/or descends down the face with aging it is a good idea to replace it approximately every 5 to 7 years with fat transplantation. This way, the results are not as dramatic that everyone notices and it effectively replaces the much needed fat that gives us a healthy, youthful appearance. In addition, face lifting can be avoided or delayed significantly.

I feel that continual fat replacement every so often is better than trying to do it all at once. The reason is because the results are much more predictable and you can only augment so much at one time with fat. You cannot augment more than 3 mm at any one time because fat requires the surrounding tissue to supply it with blood. If you put more than 3 mm of fat in, the surrounding tissues are unable to supply the middle with adequate blood leaving it to die and then be reabsorbed.