Fat grafts, fillings, and skin treatments.

There was a time when replacing tissues in an optimal position and removing excess skin in surgery, was the only viable method for rejuvenation and beautifying. Surgical procedures filled empty spaces, as well as depressed and more shriveled areas. This was, and still is, undertaken with grafts of fat tissue. Now, with the evolution and advances of technique, non-surgical injections and derma fillings have become another option.  

Let us elaborate:

Fat grafts

These grafts are widely discussed at congresses on plastic surgery, published within scientific literature and practiced in medical surgeries. The inconvenience of this method is that there is no predictable or guaranteed result within each injection session. However, the advantage is that the tissue of the patient is very much absorbed: it remains in place indefinitely.

It is possible to repeat new sessions every three to six months, knowing that each time, a little more fat will be fully integrated. Therefore, the well-informed clients who opt for this procedure, must be patient and be aware of the necessary repetition of grafts, until a satisfying end result is reached.

In addition, it has been observed that fat grafting helps improve unaesthetic scars, post burn scars and surprisingly, it has been seen to greatly improve the texture of the skin. These improvements are attributed to rich and high in fat grafted stem cells. Although this explanation has not been shown by scientific research, in practice, we have seen this to be indisputably true.  

Therefore, when I practice a facial rejuvenation surgery, a procedure I still undertake in my present practice, in most cases, a thin layer of fat grafting is place all over the face, just under the skin.  And yet, when we want to treat a surface depression or an unpleasing non-aesthetic aspect, removing it or not, we put an abundant fat graft at that region, which obtains very encouraging results.

Filling with Fillers through Injection

This is the most modern practices of beautification and rejuvenation; before permanent fillers were commonly desired. Today, this method can still be used, but the preference are fillings done with hyaluronic acid, hydroxyapatite etc… These are more commonly known as transitional or absorbable fillers, knowing that some of these last more than a year.

Permanent Fillers

The largest and most important example of “permanent fillers” is the polymethylmethacrylate. It is indeed a very interesting and effective product, if used in small amounts and always at a certain depth. Although we have never had any problem with this product, complications attributed to this product have occasionally been reported at conferences and within publications. It is not known whether these complications were due to improper practice during the application, however, or even with similar products without quality control that have invaded the market during the time of its peak use. Complications with this permanent product are extremely difficult to manage, because they cannot be re-absorbed. It is only possible to remove it, along with the fabric where it is applied.

This permanent filler is available in the market in Brazil, and is registered under ANVISA, by the Ministry of Health. Used correctly, it has great utility in applications, within regulation and in small quantities. However, the product has been replaced in popularity by the use of absorbable fillers because, although it can provide excellent and immediate results that are longer lasting – for up to one or two years; people choose this product due to in the event of a complication, it is transient and more easily manageable.  

Absorbable Fillers

This is effectively the most modern process adopted around the world. In international conferences dealing with aesthetics, it is impressive how this procedure has become the focus of attention of many plastic surgeons and customers. We believe that these hyaluronic acid based fillers, although transient, they are extremely easy to use in practice, and can be done in medical offices, avoiding the hospitalization that are needed with fat graphs, for example, as well as the  post- operative procedures. These are some of the advantages that outweigh the costs and the recovery period in a Surgical Center.

Do Fillings and Skin Treatments Substitute Plastic Surgery?

Answer: Of course, not. Plastic surgery has been “postponing aging” for some time now. At the beginning of my professional practice, the signs that indicated a need for a face-lift occurred at the age of 38 to 40-years of age. Today, generally, there are indication more evident for the need for a face lift (in general) at approximately 50 years of age.

There is a moment in which the skin becomes very flaccid, where fat increases in undesirable areas (Bulldog bags, jowls, among others), and there’s no other way to repair than the re-composition of the anatomy through a Face-lift. And this will be supplemented by cosmetic procedures through fillings and skin treatments, things that the scalpel doesn’t solve. At one point surgery is indispensable and complemented by aesthetic injectable products.

Skin treatments are mandatory, which is why the services of plastic surgery must have, as we have, the support and complementary services in dermatology.

Smoother processes are considered for the skin treatment, such as Retinoic acid and lightening products, then evolves to chemical peels, and finally to use of lasers. Among these there are a wide variety of modern devices that are less aggressive, resulting in better results with less recuperation time. The SPECTRA are among one of these devices, and has demonstrated excellent performance in removing stains, tattoos, dark circles etc… in addition to generally rejuvenating smoothness and skin texture.

Skin Treatments

The skin is the cover to our body. It plays a fundamental role in the preservation of our health and survival. On the other hand, it should be silky smooth, with minimal wrinkles so that we appear healthy and young.

The aesthetic treatment of the skin is a multidisciplinary area which combines both Dermatology and Plastic Surgery.