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General Category => Functional Surgery Questions => Topic started by: Lazlo on July 24, 2013, 06:30:47 PM

Title: FACIAL FAT GRAFTING
Post by: Lazlo on July 24, 2013, 06:30:47 PM
Just thought I'd start a thread here about fat grafting since it would help offset irregularities from jaw surgery. Specifically it can be used to augment orbital rim/malar area. Now there's a bit of controversy here. Some say it immediately absorbs, but actually fat is a living tissue and if it is harvested and grafted in the proper way it should actually last forever (or at least 10 plus years). Schendel apparently does it.

http://www.facecenterla.com/sitemap/adult-stem-cell-facial-rejuvenation.html (http://www.facecenterla.com/sitemap/adult-stem-cell-facial-rejuvenation.html)
Title: Re: FACIAL FAT GRAFTING
Post by: Lazlo on July 24, 2013, 06:39:17 PM
these are fillers but this guy also is an expert in fat grafting and this shows how he enhances some of the cheek/malar area

http://lamfacialplastics.com/the-outer-face-converting-double-concavities-into-convexities-2/ (http://lamfacialplastics.com/the-outer-face-converting-double-concavities-into-convexities-2/)
Title: Re: FACIAL FAT GRAFTING
Post by: pekay on July 24, 2013, 06:45:06 PM
there is a Beverly Hills guy that does this (fat grafting) extremely well but I can't remember his name for the life of me
Title: Re: FACIAL FAT GRAFTING
Post by: Lazlo on July 24, 2013, 06:54:05 PM
there is a Beverly Hills guy that does this (fat grafting) extremely well but I can't remember his name for the life of me

well it would be cool for sure if you let us know when you remember...
Title: Re: FACIAL FAT GRAFTING
Post by: pekay on July 24, 2013, 07:25:00 PM
this guy doesn't have an online presence at all

his website is s**tty (poorly designed) and dated, he isn't a jack of all trades either (facial procedures only)

i remember reading on another forum (MissJ i think?) that all those royal saudi family wives go to him (probably a bulls**t rumor)

Title: Re: FACIAL FAT GRAFTING
Post by: Lazlo on July 24, 2013, 07:46:10 PM
this guy doesn't have an online presence at all

his website is s**tty (poorly designed) and dated, he isn't a jack of all trades either (facial procedures only)

i remember reading on another forum (MissJ i think?) that all those royal saudi family wives go to him (probably a bulls**t rumor)

well when you figure it out let us know!
Title: Re: FACIAL FAT GRAFTING
Post by: msmixmaster on July 24, 2013, 11:07:03 PM
I think his guy is pretty famous for fat grafting too. Seen him on Vogue etc.
http://www.lipostructure.com/ (http://www.lipostructure.com/)
Title: Re: FACIAL FAT GRAFTING
Post by: earl25 on August 06, 2013, 03:34:15 PM
Just thought I'd start a thread here about fat grafting since it would help offset irregularities from jaw surgery. Specifically it can be used to augment orbital rim/malar area. Now there's a bit of controversy here. Some say it immediately absorbs, but actually fat is a living tissue and if it is harvested and grafted in the proper way it should actually last forever (or at least 10 plus years). Schendel apparently does it.

http://www.facecenterla.com/sitemap/adult-stem-cell-facial-rejuvenation.html (http://www.facecenterla.com/sitemap/adult-stem-cell-facial-rejuvenation.html)

Fat grafting in general is very iffy especially for the orbital rim. theres many issues. first and foremost imo its highly overused. Per MissJ fat is really a permanenet filler for plumping, or best when you already have the bone structure or "shelf" to put the fat on. if you don't have the structure or shelf then really implants are the only option. I know you probably sont like them, honestly I don't either but if you have a orbital rim structure issue theres no other option other than a lefort 3 which no one will do on you because the risks are huge. there no shortage of people who really need orbital rim and got fat there and are unhappy.

also fat grafting in general is iffy. you have no clue how much will stay , how it will change over time,. when I saw heonig he told me he's seen many cases where someone gets fat graphs and looks good but then over time the grafts grow (like belly fat normally does as you age ) then you look terrible and its very hard to get out. also there's a debate whether most of the fat injected is dead on injection anyway since its put through the centrifuge, and this explains the hard cysts.

if I was going to do fat I'd do the dr. seckel style fat grafting. he takes a sliver of fat shapes it to form then inserts it. very little damage to the graft.
Title: Re: FACIAL FAT GRAFTING
Post by: Lazlo on August 06, 2013, 04:17:01 PM
Fat grafting in general is very iffy especially for the orbital rim. theres many issues. first and foremost imo its highly overused. Per MissJ fat is really a permanenet filler for plumping, or best when you already have the bone structure or "shelf" to put the fat on. if you don't have the structure or shelf then really implants are the only option. I know you probably sont like them, honestly I don't either but if you have a orbital rim structure issue theres no other option other than a lefort 3 which no one will do on you because the risks are huge. there no shortage of people who really need orbital rim and got fat there and are unhappy.

also fat grafting in general is iffy. you have no clue how much will stay , how it will change over time,. when I saw heonig he told me he's seen many cases where someone gets fat graphs and looks good but then over time the grafts grow (like belly fat normally does as you age ) then you look terrible and its very hard to get out. also there's a debate whether most of the fat injected is dead on injection anyway since its put through the centrifuge, and this explains the hard cysts.

if I was going to do fat I'd do the dr. seckel style fat grafting. he takes a sliver of fat shapes it to form then inserts it. very little damage to the graft.

interesting stuff, thanks for the advice. would you recommend fillers of some sort then?
Title: Re: FACIAL FAT GRAFTING
Post by: earl25 on August 06, 2013, 06:42:44 PM
interesting stuff, thanks for the advice. would you recommend fillers of some sort then?

Depends. If you have the structure then fat or filler is ok. If you don't then imo it wont give you the augmentation you want.  I have a 1cm orbital rim deficiency fillers or fat wont do it for me. I need structure. Only implants can do it. Yes you can play with hydroxyapatite and fat and filler but it isn't the answer for structure.
Title: Re: FACIAL FAT GRAFTING
Post by: earl25 on August 06, 2013, 08:01:16 PM
not that much and its a risk because the paste can re-sorb, or migrate or lose its shape
Title: Re: FACIAL FAT GRAFTING
Post by: Tiny on August 07, 2013, 04:22:52 PM
i know arnett told me that when they use HA paste they mix it with PRP (platelet rich plasma --which is part of the reason why you give blood before the op.) and then when they use it at the osteotomy sites as well they also mix collagen and your own bone grafts. I don't know if they mix it with all that stuff for the orbital rims also, but if they did, it might suggest it would be more bone-line...

I guess it forms a psuedo-bone crystal structure but not as well organised on a micro level as real bone.

I recently started using a nano-HA toothpaste that's supposed to help recrystallise the tooth enamel.  Anyone else use it?  Results?

And finally in bone news - supplementing with calcium phosphate is supposed to be more effective than just calcium.  Which is weird to me as CaPO4 is going to break down into Ca2+ and (PO4)2- the minute it hits the stomach and the body doesn't exactly lack phosphate.

Title: Re: FACIAL FAT GRAFTING
Post by: pekay on August 07, 2013, 06:31:47 PM
I have seen many top cranios.No one will do a lefort because its too risky and quite frankly it scares me. Implants are the only route. dr. y wants to use custom silicone covered in goretex implants

are you short face syndrome?
Title: Re: FACIAL FAT GRAFTING
Post by: earl25 on August 07, 2013, 07:20:26 PM
are you short face syndrome?

whats that?
Title: Re: FACIAL FAT GRAFTING
Post by: pekay on August 07, 2013, 08:20:37 PM
whats that?

kinda like this: Figures A and B

(http://i.imgur.com/4u2OCYT.jpg)
Title: Re: FACIAL FAT GRAFTING
Post by: Tiny on August 07, 2013, 08:56:48 PM
How is this one just not a typical maxillary/midface underdevelopment case?  She looks horizontally deficient rather than vertically IMO and her

Short face syndrome cased by one or more of -
1) vertically deficient anterior height of the mandible,
2) retropositioned mandible with pronounced vertical overbite,
3) retropositioning of the maxilla with overclosure of the mandible
4) maxillary vertical deficiency and short middle third of the face

I think it generally refers to a vertical deficiency of the maxilla and often a short mandibular ramus too.  Often presents with deep overbite.  Face looks squarish and short in the middle and bottom thirds.
Title: Re: FACIAL FAT GRAFTING
Post by: Lazlo on August 07, 2013, 10:42:38 PM
I guess it forms a psuedo-bone crystal structure but not as well organised on a micro level as real bone.

I recently started using a nano-HA toothpaste that's supposed to help recrystallise the tooth enamel.  Anyone else use it?  Results?

And finally in bone news - supplementing with calcium phosphate is supposed to be more effective than just calcium.  Which is weird to me as CaPO4 is going to break down into Ca2+ and (PO4)2- the minute it hits the stomach and the body doesn't exactly lack phosphate.

could you let us know the brand of the toothpaste? thanks.
Title: Re: FACIAL FAT GRAFTING
Post by: Tiny on August 08, 2013, 04:16:42 AM
could you let us know the brand of the toothpaste? thanks.

It was a sensodyne one - Sensodyne novamin repair and protect.  T

(http://www.thegrocer.co.uk/Pictures/620xAny/5/1/5/12515_sensodyne-repair.gif)
Title: Re: FACIAL FAT GRAFTING
Post by: x on August 11, 2013, 09:36:47 AM

they all say a lefort is to risky. do you know  of any docs who do it for cosmetic reasons?
Which LeFort did they say was too risky?

you already had a jaw surgery correct?

(found a thread of yours on missj)
Title: Re: FACIAL FAT GRAFTING
Post by: earl25 on August 11, 2013, 11:23:21 AM
Which LeFort did they say was too risky?

you already had a jaw surgery correct?

(found a thread of yours on missj)

A lefort 2 or 3. I consulted several docs including dr staffenberg in nyc who was trained by kwamoto. I already had a lower jaw bsso
Title: Re: FACIAL FAT GRAFTING
Post by: Lazlo on August 11, 2013, 12:06:28 PM
kinda like this: Figures A and B

(http://i.imgur.com/4u2OCYT.jpg)


the above is a lefort 2 quadrangular. incision is made at the lower orbital rim, but the nose remains untouched. midface is brought forward.