Surgical fat transfer
Loss of volume in the eyelids and cheeks can happen due to trauma (including face bones’ fractures and previous surgical procedures), to soft tissue exposure to radiation, and to inflammatory diseases, or as a result of aging.
In addition to orbital volume loss, fatty degeneration can affect the stability of the eyelid position and the normal ability to blink and close the eyes. This volume loss can be restored by using external fillers, autologous fillers (the patient's own adipose tissue) or implants. Each filler has its own advantages.
Risks and advantages
The technique of transplanting the patient's own adipose tissue is used to restore the natural contour of the face and the areas around the eye sockets. The patient's own adipose tissue does not elicit an immune response and is usually abundant. Another advantage of adipose tissue is its stability, allowing the implant to be preserved for a long time. The patient's own adipose tissue transplant has already been proven as a reliable accompanying technique in facial reconstruction procedures in addition to aesthetic surgery. A patient's own adipose tissue transplant can be also used in other areas of the face for the lost volume restoration.
Swelling and bruising over a long period of time (in some cases, more than two months).
Contour defects: lumps, protrusions in the area where adipose tissue was transplanted
visible fat accumulation
adipose tissue migration
adipose tissue necrosis
nerve damage (reported in various countries, but very seldom)
blindness (reported in various countries, but very seldom)
CVA (reported in various countries, but very seldom)
On the day of surgery
Patient’s own adipose tissue transplant is performed in the operating room under general anaesthesia. The abdomen is the first choice of the donor area, if available, followed by an inner and outer thigh. The technique is based on the Coleman technique: the adipose tissue is collected by pumping through a non-sharp tube, filtered from unwanted content is transferred to the face and eyelid area. The fat is injected using a thin canola through a point of entry that has diameter of a very thin needle.
Guidelines after fat transfer surgery
After the surgery, the patient is requested to elevate the head slightly when lying down and to start cold compresses on the treated area. A short course of oral antibiotics will be prescribed. In addition, a small drop of ointment should be put on the entrance places. Patients experience a varying amount of bruising but a consistent amount of swelling. The patient should expect significant swelling in the first week; it will decrease significantly towards the end of the second week but may continue for another week.
Patient may usually return to social activities as early as the second week. Some of the swelling and injected fat will gradually be lost during the 12 weeks after the surgery and then the area will stabilize. Long-term results: you can expect further improvement in skin tone and texture even beyond 12 months. Sometimes, if necessary, the process of fat transfer can be repeated.