FAT GRAFTS – FACIAL

A 22 year-old model from Australia presented in our plastic surgery center in Fort Lauderdale asking for help regarding her “cheek deformity’. She had creases under her eyes as long as she can remember. She was treated with different soft tissue fillers for a number of years but with mostly unsuccessful result. A very heavy make-up is needed to camouflage “the deformity” which is not always practical in her modeling business. She had heard about our experience in facial fat grafting and wanted to explore that possibility.

Our clinical analysis demonstrated two underlying conditions; small cheek bones and separation (groove) between fat compartments in the cheeks. We discussed augmentation of weak cheek bones with small cheek implants and fat grafting on top to correct fat tissue groove. Patient decided to proceed with fat grafting only.

In twilight anesthesia we harvested small amount of fat grafts  from her thighs, prepared a viable fat graft using our standard purification procedure and injected fat grafts into her cheeks in different levels. Significant amount of fat graft material was placed deep over the cheek bones to provide augmentation of bones (instead of cheek implants). More superficial fat compartments in the cheeks were also filled and enlarged with fat grafts to fill “the groove”.

Patient is shown before fat grafting of the cheeks (left) and 5 months after augmentation of cheek bones and cheek fat pads with fat grafts (right). One can appreciate enlargement of the cheeks by comparison of  the size of the eyes before and after surgery; due to a small cheek bones patient eyes on the preoperative  images appear larger (left) then after enlargement of cheeks with fat grafts. It almost appears like a transformation from a big eyed child into a beautiful young women. This patient will need to continue with fat grafting every 2-3 years in order to keep the result.  Cheek implants are still open for discussion.

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