Procedures::Face
Fat Grafting
Fat grafting is performed to correct the other element of facial aging: the loss of volume. This procedure has steadily gained popularity in the last two decades. Refinement to the procedure with blunt cannulas for both the harvest and grafting has made it safer and more predictable. It provides improvement in the nasolabial folds and is a good way to add volume to the face. So why is it that we still use other fillers? One reason is that despite all the advances in fat grafting, it is not easy to predict how much of the fat will survive. If the fat graft takes unevenly, it can cause lumps in thin areas of the face, for example under the eyelids. Therefore, in the face, one has to be extremely careful. I would use fat grafting in deeper planes of the face to increase volume, and would inform the patient of the need to repeat the procedure if necessary. In this operation, the less you do, the more predictable the result is. The other reason for using fillers is that they are available out of a syringe and there is no need for a donor site.
Fat grafting to the face can be an office procedure where both the donor site and the recipient area are anesthetized using a local anesthetic. The amounts of fat required for the face is small, and this is one area where I can say that less is more. Recovery depends on the extent of grafting. A small area could heal without much bruising or swelling, but a whole face fat grafting can take a few weeks to heal. As matter of fact, this can take longer to heal than a facelift. The bruising is due to the fact that one is required to do multiple passes with the cannula to lay small amounts of fat per area, so that it can get a better blood supply. These multiple passes can cause more trauma to the tissues, and therefore more swelling and bruising as a result.
Otoplasty (Ear Surgery)
The most common procedure is repair of the torn ear lobe due to accidental pulling on earrings or wearing heavy earrings. Sometimes the ear lobe is not split in two, but the hole has gotten too big and unsightly. To repair this, a local anesthesia is administered, a wedge of the ear lobe is removed and the two sides are closed in layers.
The other procedure is for the prominent ears, which is usually done in teenagers and young adults. The ear is prominent because the ear cartilage is too large and the fold is missing.
