FAMI (Facial Fat Transfer)
General Information about FAMI
Liposuction removal of fat was developed by a Parisian obstetrician over 35 years ago. Since then, surgeons have tried to graft the fat harvested during the procedure to other areas of the body. Unfortunately, after a large initial over-correction of the treated area causing facial distortion, the grafted fat lasted no more than 6 months (in the best cases), and "took" unevenly, causing unwanted asymmetry. I have grafted fat to the eye socket for 17 years, which then shrinks to (at best) 50% of the size of the initial graft.
In 1989, another Parisian surgeon described a "syringe liposuction," which treated the fat more "gently," allowing more of the fat to "last" when transfered. A New York surgeon then decided to centrifuge and separate the fat, which further improved the "survival" of the grafted liposuction fat. In 1996, a South American surgeon presented results which showed that carefully harvested, handled, and grafted fat could survive intact for 5 years.
At about the same time, in Marseilles, France, Dr. Roger Amar began to inject carefully processed fat into the faces of his patients to create a more youthful appearance. After over 500 patients and 2500 injections, the fat has survived for 9 years. In April of 2002, Dr. Amar taught me his technique of transfering the fat to the 27 muscles of facial expression, allowing a natural facial rejuvenation, without incisions or scars.
This technique can be used to rejuvenate many areas of the face, from the forehead to the lips, mouth, and chin. Fat is harvested from a relatively "diet independent" area of the body, an area which does not easily loose fat, despite weight loss in other areas. This means that the facial fat grafts remain full, and the facial rejuvenation persists, despite weight fluctuations in other areas of the body. Since the face ages by loss of facial fat (not fat gain, as in the body below the neck) the effects of weight loss, exercise, and aging are reversed, or at least neutralized.
The fat is injected into and around the facial muscles in very small portions, with minimal over-correction, since the fat should not significantly shrink or absorb, and is long-lasting. This produces a natural, youthful rejuvenation of the areas treated. Face lifts cannot treat the fine wrinkles of the skin, and often cannot and do not address the creases caused by the muscles of facial expression.
For some patients, this can produce more pleasing results than a face lift, and may reduce or eliminate the need for a brow lift, eyelid surgery, Botox, or implantation of the cheeks, lips, and/or chin. Patients who may have thought of laser resurfacing for wrinkles or acne scars may be significantly improved, in a much different manner, by facial fat injections. This can also be combined with other procedures, for true, "multi-dimensional" facial rejuvenation.
The advantages of facial fat grafting (FAMI) are many:
- An office procedure with local anesthesia and oral sedation, it does not require "going to sleep."
- Performed in an office setting, this is an extremely safe procedure. Risks and complications are 1,000 to 10,000 times less than traditional facial rejuvenation techniques.
- General anesthesia is not used. Concious sedation (IV) is frequently used.
- No blood loss, cutting, incisions, stitches, scars, and a natural-looking result.
- Results can be comparable to, or much better than, "pulling" the skin taunt over a thin face.
- After the procedure, you are awake and relaxed. After a snack (if you wish) you are able to walk out of the operating suite and office and return home within 30-60 minutes.
- Very small injection cannulas are used in the hairline and other hidden areas, avoiding any telltale signs of surgery.
- In mid-Michigan, a traditional face lift costs between $6,000 and $10,000. Our FAMI is offered for $4,700 (CRNA $560 additional) with no scars or stitches, similar or better results, safer surgery, and faster recovery.
- The treatments are individually tailored for each patient and her/his needs, with injections only in those areas which show signs of facial aging.
- Men and women ages 20-70+ , in good general health, can be safely treated.
- Acne scars, wrinkled areas, lips, creases, and many other areas can now be treated with a very natural, safe, long-lasting, more affordable filler/implant, instead of collagen, Gortex, and other artificial materials.
- The fat grafts often improve the look, feel, and consistency of the skin in the areas which are treated.
- Avoids the "wind tunnel" look so common after traditional facial rejuvenation, even in Hollywood.
- Can provide improvement of the whole face which equals, and is often superior to, the results of a traditional face lift or brow lift.
- Improves many areas which simply cannot be improved by any face lift method.
- Can be used to lift the brow, rejuvenate the eyelids, and smooth the forehead, all without incisions.
What improvements are not usually possible with facial fat transfer alone?
- Excess and/or loose neck skin
- Marked excess eyelid skin, or very marked brow ptosis (drooping)
- Very large amounts of excess facial or neck skin
- Abnormalities below the chin, in the neck
- Weakness of the eyelid muscles (ptosis)
- Abnormalities of the eyelids within 1-1.5 cm. of the eyelashes
Possible Complications of Fat Grafting:
- Infection of fat graft sites, chronic or acute
- Excess and/or prolonged bruising and swelling (longer than 2-3 weeks)
- Infection of fat harvest site, where liposuction is done
- Asymmetry or irregularity in area of fat harvesting
- Over correction or under correction (can be enhanced in second procedure)
- Keloid formation (patients at risk can usually be identified)
- Hematoma (blood clot in surgical wound)
- Lip nerve injuries (problems with lip and mouth closure)
- Chronic pain & tenderness of the graft sites and muscles (for more than 2 weeks)
- Asymmetry of results in the facial muscles
- Loss of graft volume in areas of frequent Botox injections
Comparison of Filler Substances
|Filler Substance||How Long Will It Last?||Dollar Cost per cc||Collagen||2-3 months||~200||Restylene||5-8 months||~250||Hylaform||4-6 months||~250||Sculptra||1-2 years||~450||Radiance||12-14 months||~350||Fat||8-10 years||~85 or less|
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