On July 6th to July 8th of 2007, I was the invited speaker, guest surgeon, and anatomy instructor at a FAMI (facial fat grafting) course in Manila, Philippines. Twenty surgeons from Korea, Singapore, Australia, Germany, and Italy attended the three day course, organized by the Korean Aesthetic Surgery Society.
The first day included seven hours of my FAMI lecture and a welcome dinner with all attendees. I reviewed the basics of FAMI patient selection, the essential surgical techniques, and my patients’ results over a five year period.
The second day I performed live FAMI surgery for two female patients from Manila. During the first surgery, ten surgeons observed me in the operating room, while the other ten watched a “live†video feed of the surgery to an adjacent room. For the second case, they switched places, giving all of the surgeons the opportunity to observe live surgery and question me while I performed the surgery. This is a wonderful way for experienced surgeons to learn a new procedure, and I learn something new each time that I teach this way.
The third day was reserved for cadaver dissection in the Anatomy Department of the Medical School of the University of the Philippines in downtown Manila. I guided the surgeons (four doctors per cadaver) while they practiced injecting the facial muscles, then helped them dissect the muscles to view their injection results.
The course was very well accepted, and I thoroughly enjoyed teaching a wonderful, enthusiastic, international group of cosmetic surgeons. They were very attentive, grateful, and cooperative. The patients continue to E-mail me pictures of their progress, and they are looking more beautiful each week. Just as I found all of the Philippine people, the patients were genuine, sweet, extremely gracious, and very intelligent.
Not a complete stranger to Asia, I was the invited speaker and guest surgeon at a FAMI course in Seoul, Korea in 2005. My lectures were attended by over 75 physicians, while the live surgery portion was seen by 20 doctors. My 2005 demonstration of live FAMI surgery was the first such course ever given in Korea. I was chosen for that honor after I presented a paper regarding FAMI to the annual scientific meeting of the American Academy of Cosmetic Surgery.
Facial fat grafting (FAMI) is just beginning to be appreciated by patients and the cosmetic surgery community. After being taught by Roger Amar, M.D. (one of the pioneers of facial fat grafting and the developer of FAMI) in 2002, I have continued to perform (and teach) this amazing procedure. If I could perform only one cosmetic surgery, I would probably choose FAMI. The benefits are multiple, it is completely customizable for each patient’s face, and the results continue to improve for years after the procedure. Positive facial changes include volume enhancement, skin improvement, and wrinkle reduction. There is no other facial procedure which can provide these subtle but remarkable results without scars, sutures, or incisions. FAMI is not the same as “injecting fillers,†but is actual grafting of your own living fat to enhance your own facial structures.
Most amazing of all, we are almost certainly grafting adult stem cells to the facial muscles during FAMI procedures. We now know that adult fat has an abundance of stem cells, and these stem cells are retained in the purified and centrifuged fat used during FAMI. Grafted onto the facial muscles, around bone, and under skin structures, they may be able to rejuvenate facial tissues for many years after FAMI is completed.
Several of my FAMI patients who had surgery over 4 years ago have noticed that their facial skin has continued to improve since the surgery, even though it was many years ago. Recent research suggests that adult stem cells may have regenerative properties for many different tissues, and may remain active for at least 8-9 years after placement. An excellent stem cell article for non-scientists was published in National Geographic of July 2005.
I hope to continue to perform and teach the FAMI technique for many years (and many more patients) to come.
William W. Ehrlich, M.D., F.A.A.C.S.